Surgical Outcome of Patella Stabilization for Recurrent Dislocation

Author(s): Sanjay Kumar Sureen, Vinod, Kumar Singhal, Hassan Yousuf Bilal

Background: Patellar instability encompasses conditions from intermittent subluxations to dislocations. Acute patellar dislocations often result from trauma, such as a non-contact twisting injury or a direct blow. Women have a higher incidence due to anatomical and hormonal factors. Symptoms include knee pain, swelling, and instability. Nonoperative treatment is primary, but 30% of patients face recurrent instability. Surgical interventions are required for better outcomes.

Aim of the study: This study aims to evaluate the surgical outcomes and effectiveness of patellar stabilization techniques in preventing recurrent patellar dislocation.

Methods: Between January 2015 and December 2023, 25 female patients treated for recurrent patellar dislocation at the Department of Orthopedics in Prime Medical, Dubai, UAE, were included in this study. All patients had a history of laterally displaced patella, tenderness of the medial retinaculum, knee effusion or hemarthrosis, and a positive apprehension test. Inclusion criteria were limited to female patients with recurrent patellar dislocation. Exclusion criteria included primary dislocation, coexistent tibiofemoral ligament injury, bone abnormalities, TT-TG distance >20 mm, and lower limb fractures or polymyositis sequelae. Statistical analysis was conducted using SPSS, with significance set at P<0.05.

Result: The mean age of participants was 27.5 years; 36% were under 25, and 64% were 25 or older. The average BMI was 27.9 kg/m². Recurrent right knee dislocations occurred in 56% of participants. Most (92%) had no prior surgery. Dislocation frequencies were 2-3 times (44%), 4-5 times (36%), and over six times for the remainder. The mean follow-up was 3.5 years. MPLR was the most common surgery (48%), followed by lateral release (24%), tibial tubercle transfer (16%), and patellofemoral stabilization (12%). Post-surgery, 92% had partial stability, and swelling varied from none (48%) to severe (4%). The mean VAS score decreased from 6.6 to 2.7. Most returned to normal activities in 6.5 weeks. Complications were minimal, with high patient satisfaction: 48% rated outcomes as excellent.

Conclusion: The study demonstrates that patella stabilization surgery effectively improves knee stability and patient satisfaction in recurrent patellar dislocation cases. Most patients reported significant pain relief, minimal complications, and quick returns to normal activities. With 92% achieving partial stability post-surgery and 48%, these findings emphasize the importance of timely surgical intervention.