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Acute dislocation of the patella. A correlative pathoanatomic study
P I Sallay1, J Poggi, K P Speer
1Methodist Sports Medicine Center, Indianapolis, Indiana 46202, USA.
The American Journal of Sports Medicine
|January 1, 1996
Summary
Early surgical repair of patellar dislocation effectively addresses medial patellofemoral ligament tears, preventing recurrence. Most patients achieved good or excellent outcomes, returning to sports with minimal limitations after this procedure.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Radiology
Background:
- Patellar dislocation is a common knee injury with characteristic pathoanatomy.
- Understanding the associated injuries is crucial for effective treatment.
- Early surgical intervention aims to restore stability and function.
Purpose of the Study:
- To detail the pathoanatomy of patellar dislocation.
- To evaluate the preliminary outcomes of early surgical repair.
- To assess the effectiveness of medial patellofemoral ligament (MPFL) repair.
Main Methods:
- Twenty-three patients with patellar dislocation underwent radiography and MRI.
- Arthroscopic evaluation and treatment of intraarticular lesions.
- Open exploration and MPFL repair in 16 patients, with 12 followed for at least 2 years.
Main Results:
- MRI revealed significant findings including effusion, MPFL tears (87%), vastus medialis signal (78%), and bone bruises (87% lateral femoral condyle, 30% medial patella).
- Arthroscopy identified osteochondral lesions in 68% of cases.
- Open surgery confirmed MPFL tears off the femur in 94% of patients; no recurrent dislocations occurred after MPFL repair.
Conclusions:
- Surgical repair of the medial patellofemoral ligament is highly effective in preventing recurrent patellar dislocations.
- Early surgical management leads to favorable outcomes, with 58% of patients reporting good or excellent results.
- A majority (58%) of patients successfully returned to their previous sports activities with minimal or no limitations.