Zsolt Jórász1, László Hangody2, Gyula Nagy1, Gábor Vásárhelyi2

1Department of Pediatric Surgery, Bethesda Children’s Hospital, Budapest, Hungary
2Department of Orthopedics and Traumatology, Uzsoki Hospital, Budapest, Hungary

Keywords: Arthroscopy; dislocations/surgery; patella/injuries/surgery.

Abstract

Objectives: Patellar dislocation is a common problem in skeletally immature subjects. Nonoperative treatment of these dislocations results in unsatisfactory outcomes. The aim of this study was to evaluate the results of minimally invasive arthroscopic treatment for acute and recurrent patellar dislocations.
Patients and methods: Twelve patients underwent arthroscopic medial retinaculum suture for patellar dislocations. The dislocations were acute in seven patients (mean age 14 years; range 13 to 17 years) and recurrent in five patients (mean age 22 years; range 17 to 32 years). In some cases, arthroscopic medial retinaculum suture was combined with a lateral release. The patients were evaluated by physical examination and with the Lysholm-Gillquist score and the Bandi knee global assessment score. The mean follow-up period was 9.8 months (range 2 to 28 months). Two patients were excluded from the final evaluations: one was lost to follow-up and the other underwent surgery.
Results: The mean Lysholm-Gillquist score after treatment was 97.6±1.5 (range 85 to 100). The results were excellent in nine patients, and good in one patient. The global objective assessment score of Bandi was good in all the patients. None of the patients experienced recurrent luxations during the follow-up period. The patients had no complaints and were satisfied with treatment. None of them reported pain or swelling. All the knees had normal range of motion. Most of the patients returned to competitive sports activities. Some patients refrained from active sporting even though they had no physical complaints.
Conclusion: Arthroscopic medial retinacular suture combined with lateral release is a safe and effective treatment modality in acute and recurrent patellar dislocations and in chronic subluxations.