Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. A review of eight cases.
Explore the source record for details and available documents.
Adolescent↗
SEARCH · Search PubMed
Results for “Patellar Dislocation”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Patella alta and patella infera. Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle.
The Insall-Salvati method of assessing the position of the patella was applied to four groups of patients:normal patients, and those with dislocation of the patella, chondromalacia of the patella, and apophysitis of the tibial tubercle. The ratio of patellar length to tendon length was 1.0 in the normal patients, 0.8 in the patients with dislocations, 0.86 in those with chondromalacia, and 1.2 in those with apophysitis of the tibial tubercle. Patella alta may be an important cause of dislocating patella and of chondromalacia patellae. The significance of the patella infera found in the Osgood-Schlatter lesion may be one of either cause or effect.
Adult↗
[Functional treatment method following patellar dislocations].
Acute, as well as recurrent, dislocations of the patella often are treated conservatively. However, an increasing number of authors are recommending early surgical treatment for primary, traumatic, as well as congenital, dislocations of the patella. The purpose of this report was to determine, which cases should be treated by operation or conservatively by a specific patellar protection program. This program includes four phases or rehabilitation: Phase I: Antiinflammatory measures (ice, compression and elevation, non steroidal medications), specific exercises (isometrics, straight leg raises with no weight, side leg raises with no weight), active range of motion, passive range of motion with no weights, flexibility of back, hip, hamstrings, quadriceps, ankle, groin and general exercises (swimming, general conditioning and opposite extremity program). Phase II: Continue isometric program, progressive-resistive program with ankle weights, continue flexibility program, lateral step-ups if terminal extension painful, eccentric isometrics if straight leg raises painful, continue swimming, may begin low resistance cycling if motion adequate. Phase III: Isotonic progressive-resistive exercise program, exercise to fatigue using weight or similar equipment (quadriceps, hamstrings, circuit exercises). Phase IV: Slow return to sports to develop specific neuromuscular skills at that sport, continued strength and endurance training. Continue weight machines and a full range of motion, running program, continued flexibility before and after athletic play.
Braces↗
Difficult reductions in traumatic patellar dislocation.
A traumatic lateral dislocation with internal rotation of the patella can be unreducible using conventional maneuvers. These unusual dislocations may involve locking of the patella on the lateral femoral condyle. In these cases, reduction can be achieved by applying a downward force to the lateral aspect of the patella, which reduces the rotational deformity and unlocks the medial patellar facet.
Adult↗
Permanent post-traumatic patellar dislocation.
Permanent post-traumatic dislocation of the patella is an extremely rare condition, and is often confused with congenital dislocation. The anatomic abnormalities differ in the two conditions: in the former there is an adaptive flattening of the patella, in the latter there is a propensity for flexion contractures and incongruity of the patella and trochlea. Treatment options include observation, patellar realignment, and patellectomy. In the patient reported, surgical correction appeared to result in patellar alignment.
Accidental Falls↗
[Displacement of the tibial tuberosity in retropatellar cartilage damage and recurrent patellar dislocation].
In our hospital in the years 1980 till 1986 37 displacements of the tuberositas tibiae were performed in chondropathia patellae and recurrent luxation of the patella. The follow-up examination took into consideration the radiological and clinical findings, the subjective complaints and the ability of going in for sports. These clinical experiences and pressure measurements in the femoro-patellar joint show the best results after the displacement of the tuberositas tibiae according to Blauth. Additionally we recommend an accurate indication for chondropathia patellae and recurrent luxation of the patella and accompanying surgical measures.
Adolescent↗
Biomechanical evaluation of lateral patellar dislocations.
This investigation was undertaken to identify the structures torn within the medial retinaculum and localize the injury site anatomically following acute lateral dislocation of the patella in a cadaver model. The patellae of 10 fresh-frozen cadavers were translated laterally 135% of the patella width on a universal testing instrument. Magnetic resonance imaging (MRI) was performed on all specimens prior to testing and immediately following testing. Anatomical dissection also was performed on the medial retinaculum following testing. Dissection revealed avulsion fractures from the inferomedial border of the patella in 8 of the 10 knees. The medial patellofemoral ligament was injured in 8 of the 10 knees; the location of the injury varied. Tears of the medial patellofemoral ligament from the femur in 6, a midsubstance tear in 1, and stretch in 1 knee were noted. In a knee with a femoral-sided tear, an avulsion fracture of the medial patellofemoral ligament was identified. None of the cadaver knees demonstrated tears of the lateral retinaculum or medial patellotibial ligaments on dissection. Review of the MRIs revealed a medial retinaculum tear in 6 of the 10 knees. Two tears from the femur, 3 from the patella, and 1 tear from both the patella and femur were noted. An avulsion fracture was noted from the inferomedial patellar border in 3 of the 10 knees. No pathology was noted on 4 of the MRIs. When anatomically correlated, the 3 patellar retinacular tears and 3 avulsion fractures noted on MRI represented a tear of the medial patellomeniscal ligament from the patella. The femoral-sided tear represented a tear of the medial patellofemoral ligament from the femur. An appreciation of the spectrum of injury to the medial retinaculum may aid in the diagnosis of an acute dislocation of the patella and help establish the anatomical structures damaged. The pathology demonstrated in this study may explain the diversity of injury seen clinically. Whereas an avulsion fracture from the patella may represent the medial patellomeniscal ligament, a femoral-sided retinacular tear may represent the medial patellofemoral ligament. This may lead to future refinements of surgical options and anatomic restoration of the damaged structure.
Biomechanical Phenomena↗
[Pathology, diagnosis and therapy of patellar dislocation].
Patella dislocation in sports trauma is a common injury and is influenced by minor alterations or derangements of dynamic or static factors. The sulcus angle should not exceed 138 degrees and the Q angle should not be more than 15 degrees. Patella alta has some influence on the dislocation tendency, and so has weakness and atrophy of the musculus vastus medialis obliquus, causing muscular imbalance. Diagnosis is made via x-ray in tangential as well as a.p. and lateral view. Clinical examination of the patella reveals in lateral dislocation or redislocation can be provoked after positioning. Tenderness is present along the medial retinaculum associated with haemarthrosis in most of the cases. Conservative treatment includes evaluation of haemarthrosis and physiotherapy especially with regard to strengthening the vastus medialis obliquus. Surgery includes lateral release and medial capsular plication or transposition of the patellar tendon for correction of the Q-angle.
Adolescent↗
[Autofixation of the transposed tibial tuberosity in habitual patellar dislocation].
Habitual luxation of the patella is as a rule considered an indication for a stabilizing operation. As regards approaches to the surgical solution of this problem we can differentiate between operations of the proximal part of the extension apparatus, i.e. operations of the soft tissues and operations on the distal part of the extension apparatus, above all plastic operations and transposition of the insertion of the lig. patellae on the tuberositas tibiae. In the present paper the authors submit their own modification of transposition of the tuberositas tibiae, suitable in severe affections after closure of the epiphyseal space. The described technique makes it possible to anchor the transposed tuberosity by an autofixation mechanism without using osteosynthetic material. The basis of the method is removal of a small block of bone with the insertion of the lig. patellae, size 2 x 4 cm, and its insertion beneath the corticalis at a site selected in advance into an opening 2 x 2 cm with subsequent covering and stitching of the periosteum. The extent of medialization depends on testing during flexion and extension. To prevent the development of the syndrome of patellar hyperpression it is important to avoid excessive distalization of the insertion of the ligament. During the preoperative period it is recommended to apply a plaster splint for two weeks, followed by functional rehabilitation and gradual burdening; complete burdening should be attained by the third month after operation. The surgical technique was tested in a group of 16 patients at the First Orthopaedic Clinic and with regard to its simplicity and reliability the method can be recommended.
Humans↗
[Comparative evaluation of various surgical technics in the treatment of dislocated patellar fractures].
From the point of view of the different operative methods 137 patellar fractures operated on in the 3 years' material (1969--1971) of the Central Casualty Rehabilitation Institute have been analysed by the authors. 116 fractures could be re-examined 2--4 years after patients were back at work. If the operation was followed by adequate functional management, satisfactory results were found after all operations. When the patients were back at work, further improvement of the results has been observed. In the time the patients got again to work, the results of partial patellectomy seemed better,--however, after 2--4 years osteosynthesis yielded better final results. Traction loop proved more effective than cerclage. If possible, conservation and exact unionof the patella is of great importance in both juveniles and manual workers. Early functional treatment improves the late results of the operation.
Adolescent↗
Isokinetic knee extension strength and pain before and after correction of recurrent patellar dislocation.
The maximal isokinetic knee extension strength was measured in 20 patients before and after surgical correction of recurrent dislocations of the patella and the pain evoked during the recordings was rated. The preoperative muscle strength was significantly higher and pain was less severe than in a previously studied group of patients with chondromalacia or patellofemoral osteoarthrosis. Twenty months after patella realignment by a new surgical procedure including an extensive lateral release and anteromedial displacement of the tibial tuberosity by an oblique osteotomy through the anterior crest of the tibia, a significant decrease of patellofemoral pain and a slight increase of muscle strength was noted.
Adolescent↗
[Analysis of the axis in patients with patellar dislocation].
The authors investigated in 25 patients with luxations of the patella if an increased incidence of defective torsions of the leg skeleton could be demonstrated. The torsion conditions of the lower extremity can be easily shown by computed tomography. This was confirmed when 32 femur preparation and 95 sound extremities were examined. The comparison of measuring results does not show any difference between patients and control group regarding the torsion of tibia and femur and the position of the tuberosity of the tibia. Patients with luxations of the patella show an increased external rotation of the tibia with respect to the femur due to a lack of medial muscular and ligamentary guide.
Femur↗
[The horizontal patellar dislocation].
The horizontal dislocation of the patella is a very rare event and little described in literature. On the occasion of a 35 years old motor car driver accident mechanism an therapeutic management are discussed.
Accidents, Traffic↗
[Arthroscopic therapy of patellar dislocation. Surgical technique and clinical results].
Between January 1986 and August 1995, we treated 86 patients suffering from lateral displacement of the patella with arthroscopic medial tightening and lateral release after a conservative functional treatment remained unsuccessful. 49 patients were available for follow-up studies. 29 patients were treated after primary dislocation of the patella, and 20 patients after recurrent dislocations (2-20). The lateral release was performed by arthroscopy in 28 patients and in 21 patients in an open procedure. The mean follow-up time was 47.3 months. The rate of reluxation was 8%. In the opinion of the patients, 44 (90% of the follow-up) operations were evaluated as good/very good, the average Lysholm score was 87.3 +/- 13.9. The clinical results were influenced by the point of time of the operation. Patients with monoluxation showed a lower rate of reluxation (3% vs. 15%) and superior functional and subjective results than those with recurrent dislocation. However, there were no significant differences between the open and closed performed lateral release. We recommend the technique presented here as a minimal-invasive method especially for patients with monoluxation of the patella.
Adolescent↗
Acute traumatic patellar dislocation: the importance of skyline views.
Explore the source record for details and available documents.
Adolescent↗
An unusual case of irreducible intra-articular patellar dislocation with vertical axis rotation.
Explore the source record for details and available documents.
Accidents, Traffic↗
Acute traumatic patellar dislocation: the importance of skyline views.
Explore the source record for details and available documents.
Humans↗
[Diagnosis and therapy of traumatic patellar dislocation in the athlete].
Traumatic dislocations of the patella usually occur in sport activities. The review of our in-patient collective between 1980 and 1985 showed twenty traumatic dislocations of the patella among 1106 sport injuries. Most patients were adolescents. Seventeen of these injuries resulted from a typical valgus-flexion-external rotation-mechanism. Only three cases followed direct trauma. The therapy of choice in fresh traumatic dislocations of the patella in sportsmen is a suture of the medial retinaculum and if necessary refixation of osteochondral fragments. We performed operative treatment in sixteen of our own patients.
Adolescent↗