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Patellar stabilization surgeries in cases of recurrent patellar instability: a retrospective clinical and radiological audit

Irish Journal of Medical Science (1971 -) volume 190, pages 647–652 (2021)Cite this article

Abstract

Background

Patellar instability is a disabling condition that limits the functional ability and physical aspirations of patients. There are multiple anatomical structures which stabilize the patella and surgical treatment is tailored to repair the underlying aetiology.

Aims

To evaluate the clinical and radiological outcome of patellar stabilization procedures in patients with recurrent patellar instability.

Methods

We analysed 34 patients (36 knees) (mean age, 26.6) with recurrent patellar instability who underwent patellar stabilization surgery from June 2009 to September 2014. Type of procedure was dependent on the concomitant aetiological factors; tibial tuberosity osteotomy (61.76%), medial patellofemoral ligament reconstruction (67.64%), lateral release (5.88%) and trochleoplasty (2.94%). Mean follow-up was 3 years (range 9 months–6 years).

Results

At follow-up, 77% of patients were satisfied with the overall outcome of the procedure. The mean IKDC was 66.7, Lysholm 74.9. Mean patellar height decreased significantly (P < .05) to anatomical values. Pre-operatively, the mean tibial tuberosity-trochlear groove distance was 14.66 mm (55.6% at borderline/abnormal level) and 81% showed evidence of trochlear dysplasia. Complications were found in 3 patients (8.33%), 2 of which had further episodes of instability.

Conclusions

Patellar stabilization surgery is an effective method of treating patellar instability, resulting in stability of the knee in 94.4%. Despite this, patient dissatisfaction rates are quite high suggesting that this patient group, whilst mostly stable, remains significantly symptomatic from their knee. These positive results which are reflected in the recent literature represent a strong case for consideration of primary surgical stabilization in cases of patellar instability.

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Fig. 1

Data availability

All data were stored anonymously on a password-protected Microsoft Excel datasheet and were then exported to SPSS for analysis. The datasets generated and analysed during the current study are not publicly available due to patient confidentiality.

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Author information

Affiliations

  1. Department of Orthopaedic Surgery, Cork University Hospital & South Infirmary Victoria University Hospital, Cork, Ireland

    Sean Timothy O’Sullivan & James A. Harty

  2. Tallaght University Hospital, Dublin, Ireland

    Sean Timothy O’Sullivan

Authors
  1. Sean Timothy O’Sullivan
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  2. James A. Harty
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Contributions

ST O’S – Project lead and lead author. Responsible for acquisition, analysis and interpretation of data. Contributions to the conception and design of the work.

JA H – Project supervisor and lead and sole surgeon. Substantial contributions to the conception and design of the work. Substantively revised the drafted and final submitted work.

Corresponding author

Correspondence to Sean Timothy O’Sullivan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research was granted by the Clinical Research Ethics Committee of Cork Teaching Hospitals and the study was performed in accordance with the ethical standards.

Consent for publication

Not applicable.

Code availability

As above - Microsoft Excel and SPSS.

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I believe our original research study should be published in “Irish Journal of Medical Science” as it adds to the current knowledge on surgical treatment of patellar instability, particularly in Ireland, of which there is very little consensus in the published literature to date. I believe it fits in well with the aims and scope and having reviewed the journal and submission policies, there are no issues I can foresee.

Level of Evidence: III

OCEBM Levels of Evidence Working Group - The Oxford 2011 Levels of Evidence.

• All authors have approved the manuscript for submission.

• The content of the manuscript has not been published or submitted for publication elsewhere.

• All surgeries, follow-up and data extraction were performed at the South Infirmary Victoria University Hospital, Cork, Ireland.

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O’Sullivan, S.T., Harty, J.A. Patellar stabilization surgeries in cases of recurrent patellar instability: a retrospective clinical and radiological audit. Ir J Med Sci 190, 647–652 (2021). https://doi.org/10.1007/s11845-020-02344-x

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  • DOI: https://doi.org/10.1007/s11845-020-02344-x

Keywords

  • Dislocation
  • Patella stabilization
  • Recurrent instability
  • Surgery