The traumatic factor plays a prominent rôle in this condition. Two types of cases are noted: (1) the. Academic Surgeons. Upstate Orthopedics, LLP – Upstate Medical University Department of Orthopedic Surgery in Syracuse, NY is seeking a BC/BE Surgeons in. Habitual dislocation of patella. 1. Case Presentation Habitual Dislocation of Patella Dr Sushil Sharma First Year MS Orthopaedic Resident; 2.

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Initially patient had extensor lag of 15 degrees as she was immobilized in flexion. Abstract Habitual dislocation of patella is a condition where the patella dislocates whenever the knee is flexed and spontaneously relocates with extension of the knee.

MPFL reconstruction alone seems effective in habitual posttraumatic patellar dislocation in adults without any associated bone anomalies.

Support Center Support Center. Few cases of habitual dislocations have been reported [ 7 ]. Open in a separate window. Few years after the surgery, she started noticing the giving way of patella and lived for 38 years without much disability.

Corrective osteotomy for genu valgum associated with lateral dislocation of the patella, often failed to control the dislocation; and many patients with severe genu valgum did not suffer from dislocation of the patella. Shen performed combined proximal and distal procedure in 12 adult patients with habitual dislocation of patella. The displacement is painless in habitual dislocation, in marked contrast to recurrent dislocation which occurs as isolated episodes, often in response to trauma and is accompanied by pain and swelling.

Treatment of habitual dislocation of patella in an adult arthritic knee

Femoral anteversion on CT scan was identical to the contralateral side. This report shows that a case of neglected traumatic patellofemoral dislocation in childhood can progress to habitual patellofemoral dislocation in young adult. A few recurrences were seen. Preoperative radiographs anteroposterior a and dispocation view b of left knee joint showing degenerative changes.


In case of stiffness or associated bone anomalies trochlear habitua, patella alta other therapeutic procedures would be necessary. Total knee arthroplasty in bilateral congenital dislocation of the patella: Scoring of patellofemoral disorders.

Treatment of habitual dislocation of patella in an adult arthritic knee

At birth they may present with a stiff extended knee or congenital recurvatum or congenital dislocation. In a later publication, Williams said that habitual dislocation of the patella always required releases proximal to the patella and quadriceps lengthening was an essential part of treatment and must be performed proximally.

There was no recurrent dislocation or apprehension. Most authors have reported habitual dislocation in association with shortening of the quadriceps muscle, and consider that lengthening of the tendon is an essential part of the procedure to allow the patella to remain reduced after the realignment. The etiology of patellar instability is multifactorial.

It is usually asymptomatic and is often detected by the parents as an odd looking knee or is detected on routine examination in many children. The items for pain, symptoms, and leisure and sports activities were scored Stretching of the vastus medialis tendon was associated with the laxity of the medial capsule in these patients. Patella tilt was increased in a lateral view during contraction of the quadriceps but the morphology of the patella was normal.

Habitual dislocation of the patella in flexion. It is usually symptomatic when detected in adults with major symptom of patella-femoral pain and weakness during running or climbing stairs, crepitus, and joint effusion. J Bone Joint Surg. The diagnostic relevance of Q angle as an indication for distal realignment was not established in our case and we recommend tibial tuberosity-trochlear groove distance TTTG as measured by CT scan as a better tool.


In adults there may be a painful knee due to habitual dislocation and arthritis.

The most important factor is contracture of soft tissues lateral to patella. They believed that even in the presence of severe ligamentous laxity, development of the trochlear groove could be expected during the remaining growth when the eislocation is realigned at a young age. Pathophysiology Various pathological factors have been described in the pathogenesis of habitual dislocation of patella. The rest of the clinical examination, in particular the neurological, muscular, and tendon results were normal.

Quadriceps strength was rated 4 MRC grade. Contracture of the deltoid muscle pateloa the adult after intramuscular injections. Factors of patellar instability: Habitual dislocation of patella is never obvious in the young, fat-covered knee and may be missed unless actively sought. Sislocation described the difference in the pathology of recurrent and habitual dislocations.

Habitual dislocation of patella: A review

Erosion of the corresponding lateral femoral condyle was noted in all cases. Bone factors probably had only a small role in the dynamic stability of the patella. Arch Orthop Trauma Surg.

Early results in patients dislocatikn severe generalised ligamentous laxity and aplasis of the trochlear groove. Isolated repair of MPFL was possible because there was no retraction of the knee extensor apparatus or predisposing bone factors, which would have required further surgical procedures. The lateral tether is released by dividing the fibrous adhesions, which extended along the lateral intermuscular septum. A complication of intramuscular injections.

Numerous techniques have been described in the literature for the treatment of patellar dislocations. Disorders of patellofemoral joint.