Background
Neglected traumatic patellar dislocations are rare conditions nowadays. In those cases, soft tissue procedures alone are not enough, A combined approach is often indicated because there are multiple factors to attack rather than a mere torn patellofemoral ligament.
Subjects and Methods
A retrospective case series over a total of 12 patients with neglected post traumatic patellar dislocation from March 2017 to May 2020. The study included 4 males and 8 females. The right side was affected in 9 cases, while left side was affected in 3 cases. The study was approved by the Committee of Medical Ethics and the institutional review boards of Kafr El Sheikh University Hospitals. Patients were followed up both clinically and radiologically for 24 months. All patients were treated with a quadplex attack consisting of lateral release, medial patellofemoral ligament reconstruction, tibial tubercle medialization osteotomy and quadricepsoplasty.
Results
Regarding functional outcomes between pre- and final postoperative (24 months), a significant improvement for Lysholm and Kujala functional scores was observed (p<0.05). The mean Kujala score improved from preoperative value 54±9.3 to 89±1.2 points. (p<0.05). The mean Lysholm score improved from preoperative value of 75±6.3 to 90±5.4 (p<0.05). The mean VAS score improved from preoperative value of 44±3.7 to 92.2±7.1 points (p<0.05).
Conclusion
This combined approach has good results over 2 years follow up. Medial patellofemoral ligament reconstruction should be combined with other procedures in those group of patients.