Treatment of habitual dislocation of patella in an adult arthritic knee

Abstract

Habitual dislocation of the patella (HDP) is a common presentation in pediatric age unlike adults. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. However, late presentation of habitual patellar dislocation with osteoarthritis is rare and treatment plan has not yet been established. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a 50-year-old woman. Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. Quadricepsplasty, medial patello-femoral ligament reconstruction, lateral release and tibial tuberosity transfer was done as primary procedure and total knee arthroplasty, which was planned as secondary procedure, was deferred as the patient improved functionally.

Total Knee Arthroplasty in a Patient with Bilateral Congenital Dislocation of the Patella Treated with a Different Method in Each Knee

“…If using osteotomy, it will be necessary to have a long extension stem of the tibial tray to prevent such fractures. Reddy and Kondreddi reported a two-stage procedure consisting of patellar realignment followed by definitive TKA [10]. The extensor mechanism is usually short and the vastus medialis is atrophic.…”