Medial Plication Using an Arthroscopic All-Inside Technique for Treatment of Patellar Instability in Adolescents

Gang Ji; Jianwei Zhou; Jinbao Gao; Weixia Bai; Fei Wang

doi:10.1055/s-0041-1723978

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2022; 35(13): 1434-1439
DOI: 10.1055/s-0041-1723978

Original Article

Medial Plication Using an Arthroscopic All-Inside Technique for Treatment of Patellar Instability in Adolescents

Gang Ji^*

¹Department of Joint Surgery, Orthopedic, Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China

,

Jianwei Zhou^*

¹Department of Joint Surgery, Orthopedic, Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China

,

Jinbao Gao

²Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang, Shijiazhuang, China

,

Weixia Bai

¹Department of Joint Surgery, Orthopedic, Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China

,

Fei Wang

¹Department of Joint Surgery, Orthopedic, Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China

› Author Affiliations

Abstract

The purpose of this study was to present a medial plication using an arthroscopic all-inside technique for the treatment of patellar instability in adolescents. From July 2009 to June 2012, 19 patients with acute patellar dislocation were operated by this technique. Of these patients, follow-up was available in 17 patients at an average of 3 years (range: 1.5–4 years). At the follow-up, we evaluated the patients with physical examinations, radiographs, computed tomography scan, as well as the Lysholm and Kujala scoring scales. No recurrence of patellar instability has been found. The recovery of knee mobilization resulted to be good. We think this could be a valid technique to treat patellar instability in adolescents with less associated morbidity and good cosmetic results.

Keywords

knee - patellar Instability - arthroscopic - all-inside technique

Full Text

References

References
1 Hurley CPT, Richard K, Rush MAJ, Jeremy K. Patellar instability in children and adolescents. Curr Orthop Pract 2015; 26 (05) 458-465
2 Hawkins RJ, Bell RH, Anisette G. Acute patellar dislocations. The natural history. Am J Sports Med 1986; 14 (02) 117-120
3 Fithian DC, Paxton EW, Stone ML. et al. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med 2004; 32 (05) 1114-1121
4 Wang S, Ji G, Yang X. et al. Femoral trochlear groove development after patellar subluxation and early reduction in growing rabbits. Knee Surg Sports Traumatol Arthrosc 2016; 24 (01) 247-253
5 Wang F, Kang HJ, Chen BC, Chen W, Su YL, Zhang YZ. Combination of medial patellofemoral ligament reconstruction with vastus medialis advancement for chronic patellar dislocation. Chin Med J (Engl) 2010; 123 (21) 3024-3029
6 Dainer RD, Barrack RL, Buckley SL, Alexander AH. Arthroscopic management of patellar instability. Oper Tech Sports Med 2010; 18 (02) 79-82
7 Halbrecht JL. Arthroscopic patella realignment: an all-inside technique. Arthroscopy 2001; 17 (09) 940-945
8 Ji G, Wang S, Wang X, Liu J, Niu J, Wang F. Surgical versus nonsurgical treatments of acute primary patellar dislocation with special emphasis on the MPFL injury patterns. J Knee Surg 2017; 30 (04) 378-384
9 Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 2006; 14 (08) 707-712
10 Hopper GP, Leach WJ, Rooney BP, Walker CR, Blyth MJ. Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction?. Am J Sports Med 2014; 42 (03) 716-722
11 Drez Jr. D, Edwards TB, Williams CS. Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy 2001; 17 (03) 298-306
12 Buchanan G, Torres L, Czarkowski B, Giangarra CE. Current concepts in the treatment of gross patellofemoral instability. Int J Sports Phys Ther 2016; 11 (06) 867-876
13 Wilson T. The measurement of patellar alignment in patellofemoral pain syndrome: are we confusing assumptions with evidence?. J Orthop Sports Phys Ther 2007; 37 (06) 330-341
14 Nwachukwu BU, So C, Schairer WW. et al. Economic decision model for first-time traumatic patellar dislocations in adolescents. Am J Sports Med 2017; 45 (10) 2267-2275
15 Fukushima K, Horaguchi T, Okano T, Yoshimatsu T, Saito A, Ryu J. Patellar dislocation: arthroscopic patellar stabilization with anchor sutures. Arthroscopy 2004; 20 (07) 761-764
16 Abraham E, Washington E, Huang TL. Insall proximal realignment for disorders of the patella. Clin Orthop Relat Res 1989; (248) 61-65
17 Koskinen SK, Rantanen JP, Nelimarkka OI, Kujala UM. Effect of Elmslie-Trillat and Roux-Goldthwait procedures on patellofemoral relationships and symptoms in patients with patellar dislocations. Am J Knee Surg 1998; 11 (03) 167-173
18 Myers P, Williams A, Dodds R, Bülow J. The three-in-one proximal and distal soft tissue patellar realignment procedure. Results, and its place in the management of patellofemoral instability. Am J Sports Med 1999; 27 (05) 575-579
19 Conlan T, Garth Jr. WP, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 1993; 75 (05) 682-693
20 Desio SM, Burks RT, Bachus KN. Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 1998; 26 (01) 59-65
21 Sallay PI, Poggi J, Speer KP, Garrett WE. Acute dislocation of the patella. A correlative pathoanatomic study. Am J Sports Med 1996; 24 (01) 52-60
22 Kang HJ, Wang F, Chen BC, Su YL, Zhang ZC, Yan CB. Functional bundles of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 2010; 18 (11) 1511-1516
23 Yamamoto RK. Arthroscopic repair of the medial retinaculum and capsule in acute patellar dislocations. Arthroscopy 1986; 2 (02) 125-131
24 Small NC, Glogau AI, Berezin MA. Arthroscopically assisted proximal extensor mechanism realignment of the knee. Arthroscopy 1993; 9 (01) 63-67
25 Henry JE, Pflum Jr FA. Arthroscopic proximal patella realignment and stabilization. Arthroscopy 1995; 11 (04) 424-425
26 Xu H, Zhang C, Pei G, Zhu Q, Han Y. Arthroscopic medial retinacular imbrication for the treatment of recurrent patellar instability: a simple and all-inside technique. Orthopedics 2011; 34 (07) 524-529
27 Haspl M, cicak N, Klobucar H, Pecina M. Fully arthroscopic stabilization of the patella. Arthroscopy 2002; 18 (01) E2
28 Ali S, Bhatti A. Arthroscopic proximal realignment of the patella for recurrent instability: report of a new surgical technique with 1 to 7 years of follow-up. Arthroscopy 2007; 23 (03) 305-311
29 Arendt EA, Moeller A, Agel J. Clinical outcomes of medial patellofemoral ligament repair in recurrent (chronic) lateral patella dislocations. Knee Surg Sports Traumatol Arthrosc 2011; 19 (11) 1909-1914
30 Camp CL, Krych AJ, Dahm DL, Levy BA, Stuart MJ. Medial patellofemoral ligament repair for recurrent patellar dislocation. Am J Sports Med 2010; 38 (11) 2248-2254
31 Askenberger M, Bengtsson Moström E, Ekström W. et al. Operative repair of medial patellofemoral ligament injury versus knee brace in children with an acute first-time traumatic patellar dislocation: a randomized controlled trial. Am J Sports Med 2018; 46 (10) 2328-2340
32 Bryant J, Pandya N. Medial patellofemoral ligament repair restores stability in pediatric patients when compared to reconstruction. Knee 2018; 25 (04) 602-608
33 Christiansen SE, Jakobsen BW, Lund B, Lind M. Isolated repair of the medial patellofemoral ligament in primary dislocation of the patella: a prospective randomized study. Arthroscopy 2008; 24 (08) 881-887
34 Palmu S, Kallio PE, Donell ST, Helenius I, Nietosvaara Y. Acute patellar dislocation in children and adolescents: a randomized clinical trial. J Bone Joint Surg Am 2008; 90 (03) 463-470
35 Nikku R, Nietosvaara Y, Kallio PE, Aalto K, Michelsson JE. Operative versus closed treatment of primary dislocation of the patella. Similar 2-year results in 125 randomized patients. Acta Orthop Scand 1997; 68 (05) 419-423
36 Petri M, Liodakis E, Hofmeister M. et al. Operative vs conservative treatment of traumatic patellar dislocation: results of a prospective randomized controlled clinical trial. Arch Orthop Trauma Surg 2013; 133 (02) 209-213
37 Wilkens OE, Hannink G, van de Groes SAW. Recurrent patellofemoral instability rates after MPFL reconstruction techniques are in the range of instability rates after other soft tissue realignment techniques. Knee Surg Sports Traumatol Arthrosc 2019; 28 (06) 1919-1931
38 Migliorini F, Rath B, Tingart M, Meisen N, Eschweiler J. Surgical management for recurrent patellar dislocations in skeletally immature patients. Eur J Orthop Surg Traumatol 2019; 29 (08) 1815-1822
39 Kang HJ, Wang F, Chen BC, Zhang YZ, Ma L. Non-surgical treatment for acute patellar dislocation with special emphasis on the MPFL injury patterns. Knee Surg Sports Traumatol Arthrosc 2013; 21 (02) 325-331
40 Panni AS, Tartarone M, Patricola A, Paxton EW, Fithian DC. Long-term results of lateral retinacular release. Arthroscopy 2005; 21 (05) 526-531
41 Ricchetti ET, Mehta S, Sennett BJ, Huffman GR. Comparison of lateral release versus lateral release with medial soft-tissue realignment for the treatment of recurrent patellar instability: a systematic review. Arthroscopy 2007; 23 (05) 463-468