Prospective long-term results of operative treatment in primary dislocation of the patella.
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 the 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.
Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
A
A
Harilainen
J
J
Sandelin
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000473:pathology / Q000601:surgery*; D017060:Patient Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors