Patellar osteotomy and Albee's procedure for dysplastic patellar instability

Abstract

Four patients with symptomatic patellar instability and dysplasia of the patella and femoral trochlea had a dorsal closed-wedge intraarticular sagital plane patellar osteotomy and elevation of lateral femoral condyle-Albee's procedure. All patients also had a "Modified Fulkerson-Elmslie Trillat" osteotomy of the tibial tuberosity, along with a proximal realignment-lateral release and medial plication either prior to or at the time of index surgery of patellar osteotomy and Albee's procedure. At a mean follow-up of 1 (range 3 1/2–1) year, all patients had a stable patellofemoral joint. Mean loss of range of terminal flexion was 15° (range10–20°). All patients had residual patellofemoral pain, and the results at best can be described as fair. The results of this series are encouraging in this complex group of patients with patellofemoral trochlear dysplasia with patellar instability, and we do recommend this procedure as a palliative procedure in this group of patients.