GATA Haydarpaşa Eğitim Hastanesi Ortopedi ve Travmatoloji Servisi, İstanbul

Keywords: Patellar Subluxation, Proximal Reconstruction.


Introduction: In literature more than 100 surgical techniques have been determined for the surgical treatment of lateral patellar instability. The objective of the present study was to determine the short-term effectiveness of proximal reconstruction which was applied as medial plication-lateral release in patients with chronic lateral patellar subluxation.
Patients and methods: Proximal reconstruction was performed in 10 patients who had chronic lateral patellar tilt and subluxation. All patients were male with an average age of 21.7 years. All patients had a history of traumatic patellar dislocation. The average time from the begining of complaints to the surgery was 4.6 years. Patients had subluxations that were not related to a mechanical disorder and their Q angles were within the normal range. Preoperative and postoperative congruence angle and lateral patellofemoral angle were assessed on MR scans. Functional evaluation was performed according to Kujala patellofemoral scoring system.
Results: The mean follow-up was 12.8 months. The mean Kujala scoring point increased from 51.2 points preoperatively to 82.7 points postoperatively. The congruence angle changed from lateral (+) to medial(–) in 8 patients, became 0° in 1 patient, and remained on lateral (+) in 1 patient. Lateral patellofemoral angle changed from medial to lateral in all patients. The patient with the lowest score point was the patient with the congruence angle remained on lateral. This unsatisfactory result was thought to be the result of surgical insufficiency.
Discussion: Short-term results of proximal reconstruction was found satisfactory in subluxations that were not related to a mechanical disorder and the Q angle was in normal range. Functional and radiologic results will be more satisfactory if the reconstruction type is chosen selectively for each patient.