Surgical correction of medial subluxation of the patella

Abstract

We evaluated the results of a surgical procedure to correct medial subluxation of the patella in 63 patients (65 knees), most of whom had undergone a lateral retinacular release. We performed a direct repair or a reconstruction of the lateral patellotibial ligament using locally available tissue such as strips of iliotibial band or patellar tendon. Followup averaged 53.7 months (range, 24 to 99). Outcome was based on the examiner's inability to clinically reproduce the patient's painful medial subluxation and on the patient's general impression of his or her improved functional status. Forty-four patients (68%) reported improvement in their functional levels and 49 (75%) reported that they were subjectively improved by the procedure. Overall, 50 patients (80%) had a rating of good or excellent. Six knees required a second surgical reconstruction because of failure to improve or because of a reinjury. Analysis of overall clinical outcome revealed no significant relationships based on the patient's age at the time of the initial procedure, sex, or length of followup (P > 0.10). Reconstitution of the lateral patellotibial ligament effectively corrected medial subluxation of the patella and long-term results of this salvage procedure were satisfactory.