Slipping or Recurrent Dislocation of the Patella; With the Report of Eleven Cases

Abstract

Slipping or recurrent dislocation of the patella is a condition “seen almost entirely in girls or women, and is due, in large part, to the fact that the line of pull of the quadriceps extensor muscle is not straight.” Eleven patients with this condition are the basis for this paper. “... it seems to be true that, if the patella has slipped out several times without special violence, it is an evidence of joint instability... and, while the slipping may be controlled by simple measures, the weakness usually remains, and the joint is unable to stand the strain of normal use. For this reason, although bandaging, braces for the knees, the correction of flat or pronated feet, should always be tried in the early stages of the trouble before the slipping has become frequent, comparatively little is to be expected in the way of permanency of relief from such measures.... The treatment which has been most satisfactory in meeting this condition is an operation in which the outer half of the patella tendon is reattached to the tibia well to the inside of the tubercle. In this way the angle in the muscle pull is lessened or entirely removed.... Of the eight operations which have been performed in which this has been the chief feature, in seven no after-trouble has resulted, and the stability of the joints has made them equal to normal use.”