Tripple Surgical Approach for Atruamtic Recurrent Patellar Dislocation in Skeletally Mature Patients

Abstract

Background: Chronic recurrent patellar instability in skeletally mature patients is often secondary to anatomical and biomechanical factors. Conventional management being ineffective, it requires surgical management. The triple surgical technique involves MPFL reconstruction, TT osteotomy, and LR to restore patellar stability and to minimize the rate of recurrence.

Objectives: The purpose of this work is to evaluate the effectiveness of the described triple surgical treatment in decreasing the re-dislocation frequency and increasing the functional result in skeletally mature patients with atraumatic recurrent patellar dislocation.

Study design: A prospective case series

Place and duration of study: Department of Orthopedic, Traumatology and Sports medicine, MTI, LRH jan 2020 to july 2021

Methods: Thirty four skeletally mature, atraumatic recurrent patellar dislocation patients with age ranging from 18-45 years were included in this study  .In all of the patients, a triple procedure was performed including, MPFL repair, TTO, and LR. Functional outcomes were measured by preoperative and postoperative Kujala scores while recurrence data was collected over a 12 months follow-up.

Results: The mean preoperative Kujala score was 54.6 ± 8.2; the corresponding mean postoperative score was 88.9 ± 6.5 (p < 0.001). This was quite lower compared to preoperative era where patients experienced a high incidence of dislocation, only 5.9% of the patient in the study had a recurrent dislocation. The complication rates remained low while patients’ satisfaction level stood at 4.5 out of 5.

Conclusions: The triple surgical procedure is very efficient in cases with recurrent patellar dislocation and enhances knee function in skeletally mature patients. The increased Kujala scores and the low rate of complications imply that this technique provides a viable solution for the treatment of recurrent dislocation.