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PubMedDate not supplied

An evaluation of the Elmslie-Trillat procedure for management of patellar dislocations and subluxations: a preliminary report.

The Elmslie-Trillat procedure involves lateral retinacular release, medial capsular reefing, and medial transposition of the anterior tibial tubercle hinged on a distal periosteal attachment. It is an easily performed procedure and is an excellent method for realignment of the extensor mechanism in cases of dislocation and subluxation of the patella. In our series of 52 cases with 6-24 months postsurgical evaluation, 46 cases, or 88 percent were rated as good or excellent. It must be emphasized that this technique is used only if the epiphyseal plates are closed.

Adolescent↗
PubMedDate not supplied

The Elmslie-Trillat procedure: evaluation in patellar dislocation and subluxation.

The Elmslie-Trillat procedure for correction of patello-femoral malalignment was evaluated in 27 knees in 22 patients with an average followup of 42 months (minimum of 24 months). Preoperative and postoperative pain and activity levels were recorded for all knees. The quadriceps angle was recorded in 22 knees preoperatively and in 19 knees postoperatively. Good or excellent results were obtained in 81% overall and in 91% of those knees with patella alta. The postoperative quadriceps angle (Q-angle) correlated with the result. Correction of 10 degrees or less was always associated with a good or excellent result. In contrast, all patients with a fair or poor result had Q-angles at 15 degrees or greater. The preoperative Q-angle did not correlate with the eventual result. We concluded that inadequate medial displacement of the anterior tibial tuberosity may lead to unsatisfactory results and that this may be avoided by intraoperative measurement of the Q-angle; that significant distal advancement of the tibial tuberosity is not required in patella alta; and that correction of the Q-angle to 10 degrees or less correlates with a good or excellent result from the Elmslie-Trillat procedure for treatment of patella subluxation and dislocation.

Adolescent↗
PubMed1993

Pes anserinus transposition for patellar dislocations. Long-term follow-up results.

Transposition of part of the pes anserinus was used to treat 96 knees in 78 patients with recurrent, habitual or permanent dislocations of the patella. The knees with habitual (48) and permanent (27) dislocations also had extensive release of superolateral contracture. The patients were reviewed at an average follow-up of 9 years 8 months. The medial stability of the patella had been improved in all the cases. There were no recurrences in 21 knees with recurrent dislocations. There were four recurrences (5.3%) in knees with habitual and permanent dislocations due to inadequate release of the superolateral contracture and incorrect transfer of the whole of the pes anserinus. Correction of these technical errors prevented further recurrence in all four cases.

Adolescent↗
PubMed1992

New outpatient treatment of recurrent patellar dislocations.

From December 1987 through February 1991, outpatient arthroscopic procedures were done on patients experiencing recurrent dislocations of the patella. A modified Emslie-Trillat procedure was used. Twenty-four patients (27 knees) were available for follow-up. Using the criteria of Cox, excellent results were found in 78% (21 knees), whereas 18% (5 knees) were rated as good. Only 4% (1 knee) was considered fair, and none were rated poor. Most patients (96%) showed improvement. No patient suffered a postoperative dislocation. Based upon the findings of this study, it is concluded that this procedure is an effective method of treatment for patients having recurrent dislocations of the patella.

Adolescent↗
PubMed1992

[Isokinetic torque of the knee extensor and flexor in patients with recurrent patellar dislocation].

UNLABELLED: In order to establish the role of muscle strength in the recurrent dislocation of the patella, an isokinetic study was performed using BIODEX, by which the concentric (CC) and passive eccentric (PEC) torques of the quadriceps and hamstrings were measured. The angle velocity was set at 30 degrees and 90 degrees/sec. The subjects were divided into three groups: (I) non-surgical, (II) surgical and (III) normal control. In each group 20 knees were tested, and the following results were obtained. 1. Peak torque: At either 30 degrees/sec or 90 degrees/sec of velocity, it was significantly smaller in group I. On the other hand, the torque in group II was similar to that of group III. 2. E/C (eccentric torque/concentric torque) ratio: PEC was divided by CC to express a muscular strength balance. At 30 degrees/sec velocity, group I showed a significantly high E/C ratio. CONCLUSION: The knees with recurrent dislocation of the patella exhibited significantly lower peak torque and irregular curve patterns. The muscle strength, has been restored to a near-normal level in the surgical group, therefore, the muscle weakness in this disorder can be considered to be a secondary factor. The eccentric torque appeared to play a major role in the development of recurrent dislocation of the patella.

Biomechanical Phenomena↗
PubMed1989

[Surgical management of dislocated patellar fractures--therapy and results].

Between 1976 and 1985, 96 patients with 97 fractures of the patella have been operated at the 2nd Department of Trauma Surgery, University of Vienna. According to the radiographs the fractures were classified in nine apical fractures (9.3%), 34 transverse fractures (35.1%), two longitudinal fractures (2.1%), three star-like fractures (3.1%), 25 multifragment fractures (25.8%) and 24 comminuted fractures (24.7%). The methods of operation employed are: In 34 patients standard circumferential wiring, in 43 patients tension-band wiring either alone or combined with Kirschner-wires and in 13 patients partial patellectomie. One fracture was fixed with a screw alone. 47 patients with 48 fractures were followed up clinically and radiologically three to nine years postoperatively. The overall results were in 16 cases excellent, in 23 cases fair and in nine cases poor. The possible surgical procedures of the various forms of fractures are discussed referring to their longterm results.

Adolescent↗