Title
Semitendinosus tenodesis for repair of recurrent dislocation of the patella in children.
Author
Letts RM; Davidson D; Beaule P
Address
Division of Orthopaedics, Children's Hospital of Eastern Ontario, University of Ottawa, Canada.
Source
J Pediatr Orthop, 1999 Nov, 19:6, 742-7
Abstract
Recurrent dislocation of the patella is more common in girls than in boys. Although several predisposing factors may exist, patellar dislocation is most commonly associated with familial ligamentous laxity. Many surgical repairs have been described to stabilize the patella. We have found the semitendinosus transfer to the patella to result in a predictable, stable patellofemoral joint without risk of injury to the proximal tibial physis. Between January 1990 and December 1997, 29 children have been treated at the Children's Hospital of Eastern Ontario with a semitendinosus transfer for recurrent dislocation of the patella. Seven children were excluded from the study because of insufficient follow-up; consequently this series consisted of 22 children. Four children underwent bilateral repairs, hence 26 knees that have been operated on with this procedure were included in this study. There were three boys and 19 girls, with an average age at surgery of 14 years and 4 months, ranging from 8 years and 11 months to 17 years and 10 months. The average length of follow-up was 3 years and 2 months, ranging between 2 years and 7 years and 4 months. All children had experienced greater than three episodes of recurrent dislocation of the patella. Pain consistent with patellofemoral syndrome or chondromalacia was present in 17 of 26 knees. On clinical examination, 10 knees exhibited marked ligamentous laxity. There were nine positive patellar apprehension tests, and eight patellae were hypermobile. All children were treated with a semitendinosus transfer to the patella with concomitant tightening of the medial retinaculum and a lateral retinacular release. On long-term follow-up, 23 of the 26 knees (88%) were asymptomatic, and the child had returned to regular activities. Each child completed the Lysholm and the subjective component of the Zarins-Rowe questionnaire to determine the subjective results of the repair procedure. Three children complained of patellofemoral symptoms. One child experienced recurrence of the patellar dislocation, and one child developed medical patellar subluxation.
Language of Publication
English
Unique Identifier
20038014
Title
[Arthroscopic therapy of patellar dislocation. Surgical technique and clinical results]
Author
Hehl G; Rapp F; Kramer M; Kinzl L; Krischak G
Address
Abteilung Unfall-, Hand- und Wiederherstellungschirurgie, UniversitÂatsklinikum, Ulm.
Source
Unfallchirurg, 1999 Aug, 102:8, 632-7
Abstract
Between January 1986 and August 1995, we treated 86 patients suffering from lateral displacement of the patella with arthroscopic medial tightening and lateral release after a conservative functional treatment remained unsuccessful. 49 patients were available for follow-up studies. 29 patients were treated after primary dislocation of the patella, and 20 patients after recurrent dislocations (2-20). The lateral release was performed by arthroscopy in 28 patients and in 21 patients in an open procedure. The mean follow-up time was 47.3 months. The rate of reluxation was 8%. In the opinion of the patients, 44 (90% of the follow-up) operations were evaluated as good/very good, the average Lysholm score was 87.3 +/- 13.9. The clinical results were influenced by the point of time of the operation. Patients with monoluxation showed a lower rate of reluxation (3% vs. 15%) and superior functional and subjective results than those with recurrent dislocation. However, there were no significant differences between the open and closed performed lateral release. We recommend the technique presented here as a minimal-invasive method especially for patients with monoluxation of the patella.
Language of Publication
German
Unique Identifier
99414548