The traumatic factor plays a prominent rôle in this condition. Two types of cases are noted: (1) the. Academic Surgeons. Upstate Orthopedics, LLP – Upstate Medical University Department of Orthopedic Surgery in Syracuse, NY is seeking a BC/BE Surgeons in. Habitual dislocation of patella – surgical technique. Habitual Dislocation Patella a surgical case summary Vinod Naneria Girish Yeotikar Arjun.

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B Distal femoral varus osteotomy was performed.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License http: Although the patient’s medial retinaculum was extensively elongated, it was thick enough to be reefed and sutured.

Restoration of dynamic stability of the patella by pes anserinus transposition. Vastus lateralis fibrosis in habitual patella dislocation: A quadricepsplasty was considered unnecessary because he had no contracture of the quadriceps femoris.

A year-old man, construction worker, presented a habitual patellofemoral dislocation which was caused by direct trauma to the knee as a child.

Habitual dislocation of patella: A review

The indication for reconstruction of the stabilizing ligament of the patella was based on the significant functional incapacitation and the lack of appropriate conservative treatment. This case was original because of the habitual dislocation and of the excellent functional results obtained after simple surgery and a short postoperative follow-up. Tight fibrous bands between Iliotibial tract and patella. Disorders of patellofemoral joint.

Hnevkovsky O, Prague, Czechoslovakia Progressive fibrosis of the vastus intermedius muscle in children: The average age at surgery was A few complications were seen that included wound haematoma, lateral popliteal nerve palsy and wound dehiscence.

Considering that the risk of ptella stiffness would be high in our patient because of the complex procedures including lateral retinacular release and medial reefing, we used an open osteotomy technique and took care not to damage the joint capsule during surgery.


The quadriceps dsilocation not retracted. Patella tilt was increased in a lateral view during contraction of the quadriceps but the morphology of the patella was normal. We believe that the soft tissue surgery as primary procedure will buy additional time for patient to delay the TKA and proper soft tissue balancing will improve the longevity and clinical outcome of the definitive procedures.

The surgical procedure involved proximal realignment which included lateral release and a medial habitua of the VMO with a new technique of distal realignment which addressed patella alta.

Treatment of habitual dislocation of patella in an adult arthritic knee

Knee mobilization and full weight bearing was started after four weeks. Recurrent dislocation of the patella in the adult: If patella still dislocates after full flexion is achieved, distal realignment is added.

Contracture of the quadriceps muscle. A variety of surgical techniques have been introduced for the treatment of habitual dislocation of the patella with genu valgum.

Genu valgum, defects of the patella and femoral condyles were also present in a few cases of habitual dislocations.

There was no evidence of patellar maltracking or instability on detailed physical examination.

Surgical Treatment of Habitual Patella Dislocation with Genu Valgum

J Bone Joint Surg Am. The main cause of this deterioration was the onset or worsening of patella-femoral joint pain, but no patellar instability. Proximal realignment includes lateral release, reconstruction of the MPFL and quadriceps plasty.

In our patient, radiographic results have shown that instability was not caused by bone anomalies. Radiological examination revealed evidence of patella alta as defined by Insall and Salvati,[ 7 ] and Q angle was 18 degrees.


Jeffreys in described an abnormal attachment of the iliotibial tract to the patella, producing habitual dislocation in flexion.

When patella or femoral condyles show severe degenerative changes, patellectomy is advocated Macnab, Vastus intermedius was inspected and divided if tight. No single procedure has shown to be effective in the management of habitual dislocation of patella and habituaal combination of procedures involving proximal and patslla reconstruction are recommended.

The most important factor is contracture of soft tissues lateral to patella. The diagnosis of habitual posttraumatic patellofemoral dislocation was made. It is also termed as obligatory dislocation as the patella dislocates completely with each flexion and extension cycle of the knee and the patient has no control over the habitaul dislocating as he or she moves the knee 1.

As already mentioned by Fithian et al. Contracture of the Quadriceps Muscle.

The clinical and radiological outcomes of the treatment were satisfactory. A complication of intramuscular injections. He also put forward the idea that quadriceps contracture may sometimes give rise to dislocation of the patella.

Case Reports in Orthopedics

At the final month clinical follow-up, the operated knee was stable and there was no pain. Numerous techniques have been described in the literature for the treatment of patellar dislocations.

Report of three cases. He noted that in recurrent dislocation, the medial stabilization of the patella was poor disloctaion of weakness of the vastus medialis, dysplasia, generalized joint laxity, or post traumatic medial capsular laxity.