Arthroscopic proximal realignment of the patella for recurrent instability: report of a new surgical technique with 1 to 7 years of follow-up.
OBJECTIVE
Our purpose was to study the 1- to 7-year results of a new arthroscopic technique for recurrent lateral patellar dislocation or subluxation.


METHODS
The study group included 38 knees in 37 patients treated over a period of 7 years; 36 knees in 35 patients were available for review (2 were lost to follow-up). There were 26 female and 9 male patients. All patients were evaluated at a mean follow-up of 51 months (range, 1 to 7 years). The indications for surgery were recurrent dislocation in 23 knees and recurrent subluxation in 13 knees. Arthroscopic evaluation and lateral release was carried out routinely via 4 portals. A fifth medial patellar portal was used for medial plication with 3 to 7 nonabsorbable sutures. This surgical technique of realignment of the patella was first used in 1994.


RESULTS
At final follow-up, the median Lysholm score improved from 17 to 70. The results were excellent or good in 28 of 36 knees (78%), fair in 4 (11%), and poor in 4 (11%). Subjective improvement was reported by 89% of patients.


CONCLUSIONS
Arthroscopic realignment of the patella is a procedure with less morbidity and faster rehabilitation, and the results are comparable to, if not better than, those of the established open procedures.


METHODS
Level IV, therapeutic case series.
Ali
Salman
S
Department of Orthopaedic Surgery, Corbett Hospital NHS Trust, Stourbridge, West Midlands, England.
Bhatti
Arshad
A
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D031221:Knee Dislocation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors