Objective: To evaluate the clinical and
functional results of two surgical treatments of patellar dislocation in
children. Material and Methods: A prospective study was undertaken from January
1995 to December 2009. Pre-postoperatively, the clinical and roentgenographic
examinations were performed. Patellar dislocation was classified according to
Bensahel’s criteria. There were two surgical techniques performed: 1) the iliotibial
tract passing through patella (ITT), and 2) transferring
vastus medialis oblique muscle to superior border patella (VMO). Lateral
retinacula were released to restore the tension of the medial retinacula and quadricepsplasty
was used in all patients. The results of the operations were classified according
to Kujala’s functional knee-scor- ing systems. Results: 128 patients (132
knees) were operated. There were 20 males and 108 females. 94 knees (71.2%)
were Type 1, and 38 knees (28.8%) were Type 2. The ITT was in 74 patients (76
knees), and VM was in 54 patients (56 knees). Clinical signs, imaging finding
before and after the operation and operative results of these patients were
operated with ITT and VM with no
significant difference (p > 0.05).
Overall, we attained excellent results in 95 knees (72.0%), good results in 30
knees (22.7%), and fair results in 7 knees (5.3%). There have been no poor
results or recurrences so far. Conclusion: These techniques are simple, safe
and effective in skeletally immature children. Long-term follow-up of these patients
was operated ITT and these patients which were operated VMO were not different, but time for
operation was: ITT: 65 minutes, and VMO: 55 minutes.
Cite this paper
Hung, N. N. , Tan, D. and Hien, N. D. N. (2014). Analysis of Two Different Techniques for Treatment of Patellar Dislocation Due to Fibrous Quadriceps Muscle in Children. Open Access Library Journal, 1, e1003. doi: http://dx.doi.org/10.4236/oalib.1101003.
Letts, R.M., et al. (1999) Semitendinosus Tenodesis for Repair of Recurrent Dislocation of the Patella in Children. Journal of Pediatric Orthopaedics, 19, 742-774.
Laurin, C.A., Lévesque, H.P., Dussault, R., Labelle, H. and Peides, J.P. (1978) The Abnormal Lateral Patellofemoral Angle. A Diagnostic Roentgenographic Sign of Recurrent Patellar Subluxation. Journal of Bone and Joint Surgery, 60, 55-60.
Seil, R., Müller, B., Georg, T., Kohn, D. and Rupp, S. (2000) Reliability and Interobserver Variability in Radiological Patellar Height Ratios. Knee Surgery, Sports Traumatology, Arthroscopy, 8, 231-236.
Kumar, A., Jones, S., Bickerstaff, D.R. and Smith, T.W.D. (2001) Functional Evaluation of the Modified Elmslie- Trillat Procedure for Patello-Femoral Dysfunction. The Knee, 8, 287-292.
Alvarez, E.V., Munters, M., Lavine, L.S., Manes, H. and Waxman, J. (1980) Quadriceps Myofibrosis. A Complication of Intramuscular Injections. Journal of Bone and Joint Surgery, American Volume, 62, 58-60.
Ghanem, I., Wattincourt, L. and Seringe, R. (2000) Congenital Dislocation of the Patella. Part I: Pathologic Anatomy. Journal of Pediatric Orthopaedics, 20, 812-816.
Cotta, H. (1959) Zur Therapie der habituellen Patellarluxation. Archiv für orthopadische und Unfall-Chirurgie, mit besonderer Berücksichtigung der Frakturenlehre und der or-thopadisch-chirurgischen Technik, 51, 256-271.
Drez, D., Edwards, T.B. and Williams, C.S. (2001) Results of Medial Patello-femoral Ligament Reconstruction in the Treatment of Patellar Dislocation. Arthroscopy, 17, 298-306.
Deie, M., Ochi, M., Sumen, Y., Yasumoto, M., Kobayashi, K. and Kimura, H. (2003) Reconstruction of the Medial Patellofemoral Ligament for the Treatment of Habitual or Recurrent Dislocation of the Patella in Children. Journal of Bone and Joint Surgery, British Volume, 85, 887-890.