Modified Elmslie-Trillat procedure for instability of the patella

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Patellar instability is a common orthopedic condition.
• Objective instability of the patella requires effective therapeutic interventions.
• Improving patellar congruence is crucial for knee joint function.

Purpose of the Study:

• To evaluate the efficacy of modified medial transfer of the patellar ligament for objective patellar instability.
• To determine if this technique can improve the patellar congruence angle.
• To assess the long-term clinical and radiological outcomes of the procedure.

Main Methods:

• A retrospective study involving 41 operations in 37 patients (October 1987 - April 1993).
• Inclusion criteria: objective patellar instability, recurrent dislocation/subluxation, patella alta with cartilage damage, or first-time traumatic dislocation.
• Surgical technique: medialization of the medial third of the patellar ligament with a portion of the tibial tubercle. Evaluation using the Turba score and pre/postoperative X-rays.

Main Results:

• 36 knees (88%) were evaluated at a median follow-up of 62.8 months.
• Significant improvement in the patellar congruence angle (P < 0.001).
• Good or excellent subjective (1.9) and objective (0.8) Turba scores, with no reported medial subluxations or redislocations post-operatively.

Conclusions:

• Modified medial transfer of the patellar ligament is a minimally invasive and adequate therapy for objective patellar instability.
• The technique significantly improves the pathological patellar congruence angle.
• This procedure demonstrates favorable long-term outcomes with a low complication rate.