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Arthroscopically assisted proximal extensor mechanism realignment of the knee
N C Small1, A I Glogau, M A Berezin
1Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas.
Summary
This study shows a new arthroscopic surgery for knee instability and dislocation is highly effective. Most patients reported excellent outcomes, with a quick return to sports after this extensor mechanism realignment.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Recurrent patellar instability and acute patellar dislocation pose significant challenges in orthopedic surgery.
- Current surgical interventions for extensor mechanism dysfunction have varying success rates and complication profiles.
Purpose of the Study:
- To evaluate the efficacy and safety of a novel arthroscopically assisted proximal extensor mechanism realignment procedure.
- To assess patient-reported outcomes and objective results following the surgical intervention.
Main Methods:
- A prospective study involving 27 knees in 24 patients undergoing arthroscopic extensor mechanism realignment.
- The procedure involved lateral retinacular release and medial patellar retinaculum plication with vastus medialis oblique fiber plication.
- Follow-up was a minimum of 18 months, utilizing subjective patient ratings and objective clinical criteria.
Main Results:
- 92.5% of patients (25 out of 27 knees) reported good or excellent subjective outcomes for the patellofemoral joint.
- Objective assessments also demonstrated a high success rate, with only two cases of recurrent subluxation.
- Two minor complications were reported, and the average return to full presurgical activities, including sports, was 4 months.
Conclusions:
- Arthroscopically assisted proximal extensor mechanism realignment is a safe and effective treatment for recurrent patellar instability and acute patellar dislocation.
- The procedure yields high patient satisfaction and good functional recovery, with a low complication rate.
- This technique offers a promising minimally invasive option for restoring patellofemoral joint stability.