title: Long-term outcome after operative treatment of traumatic patellar dislocation in adolescents.
abstract: OBJECTIVE
  Retrospective evaluation of the long-term outcomes after surgical treatment of traumatic patellar dislocations in adolescents and identification of possible predictive factors of poor outcomes.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  University Clinic, Level I Trauma Center.
  
  
  METHODS
  All 33 adolescents, with a mean age of 14.8 years, who were treated surgically after traumatic patellar dislocation between 1994 and 2006, were involved in this study.
  
  
  METHODS
  Mini-open medial reefing and arthroscopic lateral release.
  
  
  METHODS
  The clinical outcome was evaluated with the visual analogue scale, the Lysholm score, the Kujala score, and the Tegner activity level scale. On preoperative radiographs and magnetic resonance imaging scans, trochlear dysplasia and patella alta were assessed. The variables analyzed were sex, associated osteochondral injuries, the number of redislocations before surgery, and the number of redislocations after surgery.
  
  
  RESULTS
  At the mean follow-up of 9.8 years, the mean Lysholm score was 82.6, the mean Kujala score was 84.4, the mean Tegner activity level was 4.8, and the mean visual analogue scale was 0.2. We found no significant differences in the subgroups regarding functional outcomes. Fifteen patients with patella alta and 4 patients with trochlear dysplasia were assessed radiologically. Redislocations after surgery were observed in 4 patients, 2 of them were female patients who exhibited quadriceps angles requiring tibial tubercle osteotomy to be performed after maturation.
  
  
  CONCLUSIONS
  The techniques of mini-open medial reefing and lateral release demonstrate a good functional long-term outcome and effectively prevent recurrent instability. The major predictive factor for poor outcomes and redislocations is an inadequately addressed pathology.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Trauma Surgery, Center for Musculoskeletal Surgery, University Medical Centre Mainz, Mainz, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hartmann
authors.forename: Sven-Oliver
authors.initials: SO
authors.lastname: Dietz
authors.forename: Pol Maria
authors.initials: PM
authors.lastname: Rommens
authors.forename: Erol
authors.initials: E
authors.lastname: Gercek
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010329:Patella / Q000293:injuries / Q000601:surgery*; D031222:Patellar Dislocation / Q000601:surgery*; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome