title: The results of an extensive soft-tissue procedure in the treatment of obligatory patellar dislocation in children with ligamentous laxity: a post-operative isokinetic study.
abstract: In 11 paediatric patients (seven girls and four boys, from 12 to 15 years old) with unilateral obligatory patellar dislocation and ligamentous laxity vastus medialis advancement, lateral release, partial patellar ligament transposition and Galeazzi semitendinosus tenodesis was undertaken to stabilise the patella. The diagnostic criterion for ligamentous laxity was based on the Beighton scale. Outcomes were evaluated radiologically and functionally by measurement of the range of knee movement and isokinetic testing. The evaluation also included the Lysholm knee scale. Follow-up studies took place at a mean of 8.1 years (5 to 15) post-operatively. Normal patellar tracking without any recurrence of dislocation was obtained in ten out of 11 patients. Pain related to vigorous activity was reported by nine patients. Compared with the opposite normal side, the isokinetic tests revealed a statistically significant decrease in the maximal torque values for the affected quadriceps muscle (p = 0.003 and p = 0.004), but no difference between the knee flexors (for angular velocities of 60°/s and 180°/s) (p = 0.858 and p = 0.79). The applied surgical technique generally prevents the recurrence of the disorder in children with habitual patellar dislocation and ligamentous laxity. Quadriceps muscle weakness can be expected to occur post-operatively.
authors.affiliation: Polish Mother's Memorial Hospital Research Institute, Clinic of Orthopaedics and Traumatology, Rzgowska 281/289, Lodz 93-338, Poland.
authors.forename: K R
authors.initials: KR
authors.lastname: Niedzielski
authors.affiliation: Polish Mother's Memorial Hospital Research Institute, Clinic of Orthopaedics and Traumatology, Rzgowska 281/289, Lodz 93-338, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Malecki
authors.affiliation: Polish Mother's Memorial Hospital Research Institute, Clinic of Orthopaedics and Traumatology, Rzgowska 281/289, Lodz 93-338, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Flont
authors.affiliation: Medical University of Lodz, Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Żeromskiego 113, Lodz 90-710, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Fabis
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D031222:Patellar Dislocation / Q000175:diagnosis / Q000601:surgery*; D017847:Patellar Ligament / Q000473:pathology* / Q000503:physiopathology; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D053656:Tenodesis / Q000379:methods*; D013718:Tensile Strength; D064746:Therapy, Soft Tissue / Q000379:methods; D016896:Treatment Outcome
keywords: Galeazzi semitendinosus tenodesis; Habitual patellar dislocation; Isokinetic assessment; Ligamentous laxity; Obligatory patellar dislocation