RESEARCH ARTICLE


Non-Anatomic Proximal Realignment for Recurrent Patellar Dislocation Does Not Sufficiently Prevent Redislocation



Turgay Efe*, 1, Julia Seibold 1, Markus Geßlein 2, Karl Schüttler 1, Jan Schmitt 1, Markus D Schofer 1, Susanne Fuchs-Winkelmann 1, Thomas J Heyse 1
1 Department of Orthopaedics and Rheumatology, University Hospital Marburg, Germany
2 Department of Trauma and Orthopaedic Surgery, Nürnberg Hospital, Germany


© Efe et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, D-35043 Marburg, Germany; Tel: +49 6421-58-63790; Fax: +49 6421-58-67007; E-mail: efet@med.uni-marburg.de


Abstract

Several operative techniques have been described for recurrent patellar dislocation. Clinical results vary depending on the procedure and indication. The present study aimed to evaluate the clinical outcome of Insall’s proximal realignment for recurrent patellar dislocation at mid-term follow-up. Forty-five patients were reviewed with a mean follow-up period of 49 months after having undergone Insall’s procedure. Outcome measures included reports of redislocations, complications, patient-reported outcome scores (Kujala, Tegner activity scale) and subjective assessment. No statistically significant improvements (p < 0.05) in patient-reported outcome measures were noted. Sixteen patients (35%) had poor to fair results using the Kujala score. Subjective assessment revealed that 12 patients (27%) were dissatisfied with the outcome of their surgery and would not undergo the same procedure. Ten patients (22%) had suffered from redislocation at the latest follow-up. In 4 cases (9%), intra-articular knee hematoma occurred which required arthroscopic intervention. The overall mid-term outcome of the present study shows low patient satisfaction. Non-anatomic realignment for recurrent patellar dislocation does not adequately prevent redislocation.

Keywords: Patellar instability, Insall, Proximal realignment, Redislocation.