1/18. Arthroscopic removal of a loose body osteophyte fragment after superior patellar dislocation with locked osteophytes.The authors report the case of a loose body from a fractured osteophyte after a superiorly dislocated patella with locked osteophytes. Few cases of superiorly dislocated patellae have been reported in the literature and no cases of osteophyte fracture fragments after locked osteophytes with subsequent arthroscopic loose body removal have been reported. The loose body was removed and the distal pole of the patella was debrided arthroscopically. This patient and the majority of previously reported cases, herein reviewed, had patella alta with pre-existing patellofemoral arthrosis. Patella alta in the face of patellofemoral arthrosis should be considered a risk factor for loose body formation. Therefore, recurrent superior patellar dislocation and locking osteophytes may be a relative indication for pre-emptive arthroscopic debridement of locked osteophytes.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
2/18. The use of stereolithography for an unusual patellofemoral disorder.A patient with habitual patellar dislocation which was not treated successfully by the Elmslie-Trillat procedure is described. In the knee, a unique morphologic feature of the patellofemoral joint was suspected as a cause, and a stereolithographic model was produced from the patient's computed tomography data to determine the pathologic features. Because the solid model confirmed the speculation, additional surgery was done to modify the geometry of the joint. In the surgery, cancellous bone was removed below the cartilage, and the geometry of the cartilage was modified with the subchondral bone, taking advantage of the elasticity of the bone and cartilage. The second surgery eliminated maltracking of the patella and a satisfactory result was obtained. Therefore, stereolithography is useful for the treatment of atypical patellofemoral disorders, allowing an understanding of the pathologic features and dynamic simulation of the surgery. The surgical procedure could be a promising method to alter the joint geometry without impairing the cartilage.- - - - - - - - - - ranking = 0.2keywords = dislocation (Clic here for more details about this article) |
3/18. Total knee arthroplasty for neglected permanent post-traumatic patellar dislocation--case report.Permanent post-traumatic patellar dislocation is a rare entity resulting from recurrent trauma. This uncommon condition is often confused clinically with congenital dislocation of the patella. Treatment options, although not well defined, include observation, various soft tissue and bony procedures for realigning the patella and patellectomy. To our knowledge, this is the first case reporting the use of conventional non-constrained total knee arthroplasty with patellar resurfacing and soft tissue realignment procedure for long-standing patellar dislocation in a single stage. An interesting feature of this case was the patient's ability to function reasonably well for nearly 40 years with a dislocated patella until the development of secondary osteoarthritis, and the surprisingly good recovery after total knee replacement.- - - - - - - - - - ranking = 1.4keywords = dislocation (Clic here for more details about this article) |
4/18. Intra-articular dislocation of the patella with incomplete rotation--two case reports and a review of the literature.Intra-articular dislocation of the patella is a rare clinical condition. Only forty-five cases have been reported. Most of them were encountered in adolescents and required an open reduction. We report two cases in an older age group with an incomplete rotation of the patella, which were successfully treated by closed reduction. We discuss the literature and suggest that the management depends on the degree of patellar rotation.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
5/18. Recurrent inferior patellar dislocation in an osteo-arthritic knee.A case of inferior dislocation of the patella in an 80-year-old woman with an osteo-arthritic knee is presented. This is a rare injury in the degenerate knee and the first case in which recurrence, the need for operative reduction and intra-articular damage has been demonstrated.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
6/18. Vertical patellar dislocation: a case report.Dislocation of the patella around the vertical axis is rare. Previous reports suggest reduction requires general anaesthesia and occasionally open reduction is necessary. We describe a case of dislocation of the patella around its vertical axis with impaction in the intercondylar notch of the femur following minor trauma. Successful reduction was achieved without the need for general anaesthesia.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
7/18. The three in one procedure: how I do it.Recurrent patella dislocation is common, and selection of an appropriate stabilisation procedure is important for a successful outcome. We describe a combined proximal and distal realignment procedure to adjust soft tissue tension around the patella. This procedure, the 'Three in One' involves a combination of a lateral release, vastus medialis obliquus muscle advancement, and transfer of the medial third of the patellar tendon to the medial collateral ligament. This is a safe, reliable procedure for patients with recurrent dislocation of the patella resulting from an imbalance of soft tissue tension around the patella, but with a normally sited patella and normal trochlea.- - - - - - - - - - ranking = 0.4keywords = dislocation (Clic here for more details about this article) |
8/18. The management of superior dislocation of the patella with interlocking osteophytes--an update on a rare problem.The superior dislocation of the patella with interlocking osteophytes is a rare condition. A review of the English literature revealed only 12 reported cases. The purpose of reviewing these case reports is to highlight the unusual presentation and the injury mechanism in 2 of our patients, and to present our treatment algorithm. Closed reduction with manipulation of the patella, with or without anaesthesia, was performed without difficulty. We recommend an intermediate step of trying a regional nerve block before proceeding to general anaesthesia. Our patients had full range-of-motion after reduction and they were symptom-free after 3 years of follow-up. There were no recurrent dislocations in our patients.- - - - - - - - - - ranking = 1.2keywords = dislocation (Clic here for more details about this article) |
9/18. Osteochondral injury to the mid-lateral weight-bearing portion of the lateral femoral condyle associated with patella dislocation.We report on a series of 7 patients who presented with patella dislocation and were found to have osteochondral fracture (OCF) of the weight-bearing portion of the lateral femoral condyle either through preoperative studies or by identification of the lesion during arthroscopy. Treatments included open reduction and internal fixation, debridement, and microfracture of the lateral femoral condyle. Although not as common as osteochondral injuries to the medial facet of the patella and the anterior lateral portion of the lateral femoral condyle, osteochondral injury to the weight-bearing portion of the mid-lateral femoral condyle does occur with patella dislocation and was recognized in these 7 patients. The surgeon who treats known patellofemoral dislocations should be aware of this uncommon lesion to ensure detection and appropriate treatment. Also, in the case of uncertainty about the mechanism of injury, recognition of this lesion should heighten suspicion of patellofemoral dislocation.- - - - - - - - - - ranking = 1.6keywords = dislocation (Clic here for more details about this article) |
10/18. Arthroscopic patellar "bankart" repair after acute dislocation.We present a case of acute patellar dislocation in a skeletally immature patient treated with arthroscopic medial patellofemoral ligamentous complex repair using suture anchors with a horizontal mattress suture technique. patellar dislocation is a common problem in the skeletally immature. Treatment is controversial for first-time dislocators because of the high rate of recurrent instability and functional disability in these patients. Surgical repair of the medial restraints may decrease recurrent instability, although anterior knee pain and crepitus is a common finding after open surgical techniques. Arthroscopic medial retinacular imbrication has been described for patients with persistent instability with good short-term results. Acute dislocations may cause avulsion of the medial patellofemoral ligamentous complex from the patella; this is amenable to direct primary repair to prevent recurrent instability and avoid the morbidity of open surgery. This technique recreates normal anatomy and function with minimally invasive surgery.- - - - - - - - - - ranking = 1.4keywords = dislocation (Clic here for more details about this article) |
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