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The clinical and radiological results of individualized surgical treatment depending on pathologic abnormalities in recurrent patellar dislocation: low recurrence rate, but unintended patella baja

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the clinical and radiological outcomes and chondral lesion change using individualized surgery for recurrent patellar dislocation.

Methods

A total of 31 knees with recurrent patellar dislocation underwent surgery depending on individual pathologic abnormalities. Pathologic abnormalities including medial laxity, lateral tightness, increased tibial tuberosity (TT)-to-trochlear groove distance (>20 mm), and patella alta (Caton–Deschamps ratio >1.2) were evaluated in each patient. The abnormalities were corrected through medial patellofemoral ligament reconstruction, TT distalization, TT anteromedialization, and lateral retinacula release. The mean follow-up period was 33 months.

Results

There was one recurrent case (3.2%), requiring additional surgery. The mean Kujala scores were significantly (P = 0.002) improved from 75.8 (SD 12.4) to 84.6 (SD 13.1). Tegner scores were significantly improved from 3.7 (range 1–9) to 5.4 (range 2–9) (P < 0.001), as were and visual analogue scale pain scores from 4.7 (SD 2.5) to 2.6 (SD 2.2) (P = 0.001). Caton–Deschamps ratio was significantly decreased from 1.1 (SD 0.2) to 0.9 (SD 0.1) (P < 0.001), regardless of TT distalization. Chondral lesions of the patella and trochlear groove were improved or maintained in 57.1 and 71.4% of patients, respectively.

Conclusion

Individualized surgery in recurrent patellar dislocation was effective and safe with a low recurrence rate. However, the possibility of unintended patella baja, which might be related to post-operative anterior knee pain, should be considered.

Level of evidence

IV.

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Acknowledgements

We thank Kang Min Sohn for analysis with statistics, and Chul Kim for writing and revision manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Konyang University Hospital, Konyang University School of Medicine, Daejeon, Korea

    Do Kyung Lee

  2. Department of Orthopedic Surgery, Samsung Medical Center and Department of Health Sciences and Technology and Department of Medical Device Management and Research, SAIHST Sungkyunkwan University School of Medicine, Seoul, Korea

    Joon Ho Wang

  3. Department of Orthopedic Surgery, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, Changwon, Korea

    Seung Hoon Kang

  4. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jun Ho Kim

  5. Department of Orthopedic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    Russel Haque

  6. Department of Orthopedic Surgery, Kang-Dong Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Korea

    Byung Hoon Lee

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  1. Do Kyung Lee
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Correspondence to Joon Ho Wang.

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The authors declare that they have no conflicts of interest in the authorship and publication of this contribution.

Funding

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI10C2020).

Ethical approval

Ethical approval for the present study was obtained from the Institutional Review Board of Samsung Medical Center (Study No. 2016-01-033-003).

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For this retrospective study, formal consent is not required.

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Lee, D.K., Wang, J.H., Kang, S.H. et al. The clinical and radiological results of individualized surgical treatment depending on pathologic abnormalities in recurrent patellar dislocation: low recurrence rate, but unintended patella baja. Knee Surg Sports Traumatol Arthrosc 26, 2558–2567 (2018). https://doi.org/10.1007/s00167-017-4697-1

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