Mini-open medial reefing and arthroscopic lateral release for the treatment of recurrent patellar dislocation: a long-term follow-up (SS-52)

Abstract

Twenty-two patients (23 knees) underwent a mini-open medial reefing and arthroscopic lateral release for the treatment of recurrent patellar dislocations with an average follow-up of 4.4 years (range, 1.4–14 years). The average age at the first dislocation was 15 years (range, 5–26 years) and the average age at surgery was 23 years (range, 12–65 years). All patients suffered multiple recurrent dislocations. There was 1 postoperative dislocation (4%) and 1 recurrent subluxation (4%). The average Kujala knee score was 88.2 ± 13.5, with overall good scores in each category. The lowest scores involved squatting (5.7), abnormal painful knee-cap movements (subluxations) (7.1), and jumping (7.9). Overall, there was a statistically significant increase from the preoperative Tegner score of 3.7 ± 1.9 to the postoperative Tegner score of 6.9 ± 2.0 (P < .001). Six patients (26%) rated their result as excellent, 15 patients (65%) rated their result as good, 2 patients (9%) rated their result as fair, and 0 patients (0%) rated their result as poor. All 22 patients (100%) stated this procedure was worthwhile. Radiographically, there was a statistically significant improvement in the congruence angle (normal, −8.0° ± 6.0°) from 15.2° ± 15.7° (range, 0.0° to +44.0°) preoperatively to -11.2° ± 9.9° (range, −20.0° to +10.0°) postoperatively (P < .001) and in the lateral patellofemoral angle (normal, >0°) from 0.1° ± 7.5° (range, −10° to +8°) preoperatively to 8.0° ± 3.0° (range, 0.0° to +11.0°) postoperatively (P < .001). We feel our mini-open technique provides anatomic restoration with limited morbidity and cosmetically appealing results. Furthermore, our re-dislocation rates favor comparably with traditional, more extensile open approaches.