A Combined Procedure For Irreducible Dislocation Of Patella In Children With Ligamentous Laxity: A Preliminary Report

Abstract

Objectives: Irreducible patellar dislocation accompanying ligamentous laxity is rarely seen in pediatric patients. Most common complaints due to this condition are inability to walk, delayed walking and difficulties with orthotics. The purpose of this retrospective study is to describe a novel surgical technique to treat dislocated patella in patients with symptomatic ligamentous laxity.
Patients and Methods: Fourteen knees of nine patients operated by a single surgeon between 2009-2012 were included in the study. The tensor fascia is divided into two strips and these strips are passed via the joint and sutured on to themselves. The combined procedure additionally includes lateral capsular release, vastus lateralis resection, medial capsular plication and z-plasty of rectus femoris tendon.
RESULTS: Mean age at the time of surgery was 6.9 ± 3.3 years (range: 4-13). The mean follow-up was 37.6± 10.9 months (range: 26-49 months). Patellofemoral instability was restored for all patients by using combined surgical technique. Patellar lateralization developed in two patient whom stability was obtained with secondary medial plication.
CONCLUSION: Our results showed that this combined surgical procedure stabilizes the knee and treats patellar dislocation accompanying ligamentous laxity in pediatric patients.