Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria (original) (raw)
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Surgical Outcome of Patella Stabilization for Recurrent Dislocation
Background: Patellar instability encompasses conditions from intermittent subluxations to dislocations. Acute patellar dislocations often result from trauma, such as a non-contact twisting injury or a direct blow. Women have a higher incidence due to anatomical and hormonal factors. Symptoms include knee pain, swelling, and instability. Nonoperative treatment is primary, but 30% of patients face recurrent instability. Surgical interventions are required for better outcomes. Aim of the study: This study aims to evaluate the surgical outcomes and effectiveness of patel
Patellofemoral Dislocation Recurrence After a First Episode: A Case-Control Study
Orthopaedic Journal of Sports Medicine, 2021
Background: Lateral patellar dislocation can become a recurrent problem after the first episode. Identifying those patients who are at increased risk of redislocation is important for the treatment decision-making process. Purpose: To identify clinical and radiologic risk factors for recurrence of patellar dislocation after a first episode. Study Design: Case-control study; Level of evidence, 3. Methods: The study included patients with lateral patellar dislocation and a 1-year minimum follow-up who were seen between 2011 and 2018. Patients aged 10 to 65 years were included. Patient characteristics, physical examination (patellar apprehension, J sign), and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati ratios were used to evaluate patella alta. High-grade trochlear dysplasia was defined as Dejour types B, C, and D. Results: A total of 130 patients (139 knees) with primary lateral patellar dislocation were included. Recurrent dislocation was seen in 83 knees (59.71...
Knee Surgery, Sports Traumatology, Arthroscopy, 2017
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.
The patellofemoral joint: from dysplasia to dislocation
EFORT open reviews, 2017
Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors.The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators. Therefore, a comprehensive evaluation of all the radiographic, MRI and CT parameters can help the clinician to assess patients with primary and recurrent patellar dislocation and guide management.Patellofemoral dysplasia still represents an extremely challenging condition to manage. Its controversial aetiology and its complex biomechanical behaviour continue to pose more questio...
Results in the treatment of recurrent dislocation of the patella after 30 years' follow-up
Knee Surgery Sports Traumatology Arthroscopy, 1995
The authors compare the clinical and radiographic outcome in patients with comparable bilateral recurrent patellar dislocation treated surgically on only one side, to clarify the appropriateness of the surgical indication. Sixteen patients were evaluated at an average follow-up of 30 years (20–45); all had been treated by the Roux technique. The results on both the operated and the unoperated knee
Prospective long-term results of operative treatment in primary dislocation of the patella
Knee Surgery, Sports Traumatology, Arthroscopy, 1993
Among 53 prospectively studied patients who had undergone operative treatment of primary patellar dislocation, 9 (17%) suffered recurrence within an average follow-up of 6.5 years. All the redislocations occurred in female patients. The patients with recurrence also suffered first-time patellar dislocation in their unoperated knee during the follow-up significantly more often (P < 0.01) than the patients with stable knees. Patients with redislocations were more often dissatisfied with their outcome than the stable group, mainly because of annoying anterior knee pain (P < 0.05). Preoperatively the patients with redislocation had had more pronounced pathological patellofemoral congruity (Laurin's projections) in both the operated knee (P< 0.05) and the, at that time uninjured, control knee (P<0.05). To improve the results of operative treatment for acute patellar dislocation, surgery should be aimed at correcting the underlying pathology. In grossly and symmetrically pathological cases of patellofemoral articulation, a distal realignment procedure should be considered. Otherwise conservative treatment may be justified.
Management of the First Patellar Dislocation: A Narrative Review
Joints
First patellar dislocation is a common injury of the knee, involving often adolescents and the active population. The consequences of the first episode can be various and potentially disabling. Among these, acute patellar dislocation can often result in recurrent patellar instability. Recurrent patellar instability is certainly multifactorial but depends primarily on the injury of the medial patellofemoral ligament (MPFL), the major soft-tissue stabilizer of the patella. Some classifications are extremely useful in establishing the diagnosis and therapy in patellofemoral disease, in particular in terms of instability. Among those, Henri Dejour and WARPS (weak atraumatic risky anatomy pain and subluxation)/STAID (strong traumatic anatomy normal instability and dislocation) classifications are certainly the most frequently used. There is no clear agreement on the management of the first patellar dislocation. A conservative approach seems to be the first choice in most of cases, but th...