Recurrent dislocation of the patella

The author describes the origin and the clinical signs of the disease.     

Recurrent dislocation of the patella and the Goldthwait operation

In this study 17 patients with recurrent dislocation of the patella were followed up 10 years after their Goldthwait operation. The subjective and clinical findings were excellent or good in 70%. X-radiographs indicated osteoarthritis of the femoropatellar joint in 60%. Concerning the aetiopathological factors, we found an increased external torsion of the afflicted extremity (measured by computed tomography).     

Recurrent dislocation of the patella. Relation of treatment to osteoarthritis.

Eighty-one knees surgically treated and twenty-six conservatively treated for recurrent dislocation of the patella in seventy-eight patients were studied. The average follow-up on the surgically treated knees was eight years and on the conservatively treated knees, sixteen years. In the non-surgical group dislocations tended to become less frequent with advancing age and there was very little evidence of osteoarthritis. After the sixty-nine tibial tubercle transfers there was a 20 per cent recurrence rate; further procedures were often needed, and the incidence of late osteoarthritis was disturbingly high. After the twelve soft-tissue corrections without movement of the tibial tubercle, dislocation recurred in three, but late osteoarthritis was not seen.     

Recurrent dislocation of patella following lateral retinacular release. A case report

A case is presented with several total dislocations of patella after an operative lateral retinacular release for chondromalacia patellae. The patient, a 27-year-old woman, had no history of preoperative luxations or subluxations. She had, however, a Q-angle of 20 degrees--a fact that may have been significant in the pathogenesis.     

Recurrent dislocation of the patella. Histochemical and electromyographic evidence of primary muscle pathology

The role of muscle function in the aetiology of recurrent dislocation of the patella has been examined. Eleven of the 12 patients we studied had joint hypermobility. Muscle biopsies from eight of nine patients treated by surgery had a predominance of abnormal Type 2C fibres, and three of six patients whose quadriceps muscles were studied by electromyography also had abnormal results. Our preliminary findings suggest that there may be a primary muscular defect in many cases of recurrent dislocation of the patella.     

Intra-articular dislocation of the patella

A very rare case of intra-articular dislocation of the patella in a 10-year-old boy is presented. Closed reduction was successful. After reduction, X-rays showed normal patello-femoral alignment.     

Superior dislocation of the patella

A case of superior dislocation of the patella with locked osteophytes is described and the literature reviewed.     

Congenital dislocation of the patella

Congenital dislocation of the patella may occur as a persistent lateral dislocation of the patella that presents with a knee flexion contracture and the patella tethered lateral to the femoral condyles or as an intermittent dislocation of the patella. In the latter syndrome, the patella dislocates completely with each flexion and extension cycle of the knee and is best termed obligatory dislocation of the patella, because the patient has no control over the patella dislocating as he or she moves the knee. The first type of congenital dislocation, which is fixed, often is associated with syndromes such as arthrogryposis and should be corrected surgically by lateral release and realignment of the patella. Obligatory dislocation of the patella tends to be an isolated dysplastic anomaly and may be relatively well tolerated. Rebalancing of the patella usually is done at a later age because of less interference with function. The current author describes the natural history of patella femoral dysplasia, detailing the pathologic changes that are present, and recommends surgical techniques for correcting both types of congenital dislocation of the patella.     

Habitual dislocation of the patella

Summary A case of bilateral habitual dislocation of the patella associated with cleft lip and palate, and short metatarsals, metacarpals and phalanges is reported. The possible cause of habitual dislocation is discussed in the light of 20 cases which have been seen by the author.

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Résumé Présentation d'un cas de luxation bilatérale habituelle de la rotule associée à un bec-delièvre et à une briéveté des métatarsiens, des métacarpiens et des phalanges. L'étiologie de la luxation habituelle est discutée à la lumière des 20 cas observés par l'auteur.