Arthroscopic proximal realignment of the patella for recurrent instability: report of a new surgical technique with 1 to 7 years of follow-up

Abstract

Purpose: Our purpose was to study the 1- to 7-year results of a new arthroscopic technique for recurrent lateral patellar dislocation or subluxation.

Methods: The study group included 38 knees in 37 patients treated over a period of 7 years; 36 knees in 35 patients were available for review (2 were lost to follow-up). There were 26 female and 9 male patients. All patients were evaluated at a mean follow-up of 51 months (range, 1 to 7 years). The indications for surgery were recurrent dislocation in 23 knees and recurrent subluxation in 13 knees. Arthroscopic evaluation and lateral release was carried out routinely via 4 portals. A fifth medial patellar portal was used for medial plication with 3 to 7 nonabsorbable sutures. This surgical technique of realignment of the patella was first used in 1994.

Results: At final follow-up, the median Lysholm score improved from 17 to 70. The results were excellent or good in 28 of 36 knees (78%), fair in 4 (11%), and poor in 4 (11%). Subjective improvement was reported by 89% of patients.

Conclusions: Arthroscopic realignment of the patella is a procedure with less morbidity and faster rehabilitation, and the results are comparable to, if not better than, those of the established open procedures.

Level of evidence: Level IV, therapeutic case series.