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Orthop Surg 2020 Apr 11;12(2):679-685. Epub 2020 Mar 11.

Investigation performed at Center for Joint Surgery, Third Affiliated Hospital of Guangxi Medical University, Nanning Second People's Hospital, Nanning, China.

Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. At present, open reduction is often used to treat osteochondral fractures. Read More

Trauma Case Rep 2020 Apr 17;26:100277. Epub 2020 Jan 17.

Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, PR China.

Hoffa fracture combined with tibial shaft fracture and multiple ligament avulsion injuries is extremely rare. Herein, we report a case of medial Hoffa fracture with associated fracture of tibial shaft and avulsion fractures of multiple ligaments secondary to knee dislocation. A 17-year-old female with history of a motorcycle accident was referred to our hospital after knee joint reduction at a regional trauma center. Read More

Zhongguo Gu Shang 2019 08;32(8):772-774

Department of Orthopaedics, Shanxi Provincial People's Hospital, Taiyuan 030012, Shanxi, China;

Rev Bras Ortop (Sao Paulo) 2019 Feb 1;54(1):90-94. Epub 2019 Mar 1.

Departamento de Ortopedia e Traumatologia, Hospital de Cascais Dr. José de Almeida, Cascais, Portugal.

Irreducible patella dislocations are rare and are usually associated with complex mechanisms. The authors report the clinical case of an irreducible lateral patellar dislocation due to an anatomical variant. The authors assisted a 16-year-old patient who presented with a lateral patella dislocation that was impossible to reduce by closed manipulation, even under general anesthesia. Read More

Medicine (Baltimore) 2019 Jun;98(24):e16011

Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.

Rationale: Upper pole sleeve fractures of the patella are rare in adolescents; however, they are serious injuries that require early diagnosis and treatment.

Patient Concerns: We present a rare case of a 15-year-old girl who suffered a sleeve fracture at the superior pole of the right patella. The patient had a history of dislocation of the patella 2 weeks ago. Read More

BMJ Case Rep 2019 Apr 24;12(4). Epub 2019 Apr 24.

Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.

Horizontal intra-articular dislocation of the patella is a very rare traumatic entity. We present an unusual case of horizontal intra-articular dislocation in which the patellar articular surface was facing upwards besides having an avulsion of the quadriceps tendon from the superior pole. There was associated posterolateral knee subluxation, which has not been described with intra-articular dislocation of the patella. Read More

J Knee Surg 2019 Aug 1;32(8):710-713. Epub 2019 Mar 1.

Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida.

Conclusive evidence supporting a clinical difference between posterior-stabilized (PS) and cruciate-retaining (CR) designs in total knee arthroplasty (TKA) does not currently exist, despite both designs being used for decades. Proponents of PS designs that employ a cam-and-post mechanism cite in vivo fluoroscopic data that demonstrate improved posterior rollback; however, optimal rollback has never been correlated to superior clinical outcomes. Recently, anterior-lipped and more conforming CR bearings, such as ultracongruent, medial pivot, and dual-pivot designs, have been used to substitute for the posterior cruciate ligament and obviate the need for the cam-post mechanism of a traditional PS design. Read More

Unfallchirurg 2019 Jan;122(1):6-16

Unfallchirurgische Abteilung, Landeskrankenhaus Horn, Spitalgasse 10, 3580, Horn, Österreich.

While fractures around the knee are known to be rare, physicians have encountered a rise in the frequency due to the increased participation of children and adolescents in high-impact sports at a younger age. Even if the treatment of fractures in some cases resembles that in adults, the diagnostics and treatment in childhood and adolescence require a hígh level of experience in order avoid possible sequelae and to enable early recognition. Thorough diagnostics using clinical and imaging investigations as well as a precise weighing up of the treatment are essential to minimize differences in leg length and axial malpositioning of the leg. Read More

Am Fam Physician 2018 11;98(10):570-576

West Virginia University School of Medicine-Eastern Campus, Harpers Ferry, WV, USA.

Braces and splints can immobilize and protect joints, reduce pain, decrease swelling, and facilitate healing of acute injuries. They are also used for injury prevention and chronic pain reduction, and to alter the function of a joint. The medial unloading (valgus) knee brace is an option for patients with medial knee osteoarthritis, but evidence of long-term benefit is limited. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 13;27(2):652-658. Epub 2018 Oct 13.

Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: Increased femoral antetorsion influences patellofemoral joint kinematics. The aim of this study was to retrospectively evaluate the clinical outcome after derotational osteotomies and combined procedures in patients with patellofemoral instability.

Methods: All patients with derotational osteotomies and combined procedures in patients with patellofemoral instability and increased femoral antetorsion performed between 2007 and 2016 were retrospectively analyzed. Read More

Unfallchirurg 2019 Feb;122(2):95-102

Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland.

Intramedullary nailing was originally conceived for the stabilization of shaft fractures of long bones. Due to new nail designs and multiple interlocking possibilities, the spectrum of nailing has significantly increased. Nailing of fractures beyond the isthmus is technically challenging because fractures need to be reduced before the nailing procedure starts. Read More

BMJ Case Rep 2018 Sep 14;2018. Epub 2018 Sep 14.

Trauma and Orthopaedic Department, West Hertfordshire Hospitals NHS Trust, Watford, UK.

We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Read More

J Exp Orthop 2018 Sep 10;5(1):34. Epub 2018 Sep 10.

Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, SW7 2AZ, UK.

Background: Vastus Medialis Muscles (VMM) damage has been widely identified following patellar dislocation. Rehabilitation programmes have been suggested to strengthen the VMM and reduce clinical symptoms of pain and instability. This controlled laboratory study investigated the hypothesis that reduced Vastus Medialis Obliquus (VMO) and Vastus Medialis Longus (VML) muscle tension would alter patellar tracking, stability and PFJ contact pressures. Read More

Joints 2018 Jun 22;6(2):80-84. Epub 2018 Jun 22.

Orthopaedic Unit, Casa di Cura "Villa Igea" Hospital, Ancona, Italy.

 The aim of the study was to test the distalization and medialization of the tibial tuberosity (DMTT) for the treatment of patellar instability associated with patella alta, focusing on residual instability and pain.  Twenty-four consecutive patients (26 knees) suffering from patellofemoral instability and patella alta were treated by DMTT. Two groups were identified, which differed for documented history of frank patella dislocation. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Dec 4;26(12):3572-3581. Epub 2018 Jun 4.

Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.

Purpose: Valgus deformities of the lower extremity influence patellofemoral joint kinematics. However, studies examining the clinical outcome after treatment of patellar instability and maltracking due to valgus deformity are rare in recent literature. This study's purpose is to analyze the clinical results after combined distal femoral osteotomy (DFO) for treatment of patellar instability. Read More

Eur J Trauma Emerg Surg 2018 08 7;44(4):637-642. Epub 2018 Mar 7.

Department of General-, Trauma- and Reconstructive Surgery, Munich University Hospital, Nußbaumstr. 20, 80336, Munich, Germany.

Purpose: Joint dislocations occur frequently in prehospital settings. The medical specialities of emergency physicians are heterogeneous. Decision making and the success rates of reduction attempt can vary greatly. Read More

Int Orthop 2018 12 3;42(12):2797-2806. Epub 2018 Mar 3.

Department of Orthopaedic and Traumatology Surgery, Louis Caty hospital, Epicura Baudour, Saint-Ghislain, Belgium.

Purpose: Lateralized tibial tubercle is a cause of patellar instability. Before proceeding with reduction of the tibial tubercle-trochlear groove (TT-TG) distance, surgeons prefer to know whether this distance is pathologic. However, the pathological value remains discussed and may vary with the size of the knee. Read More

BMJ Open Sport Exerc Med 2018 13;4(1):e000273. Epub 2018 Jan 13.

School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, UK.

Objectives: To use a musculoskeletal model of the lower limb to evaluate the effect of a strength training intervention on the muscle and joint contact forces experienced by untrained women during landing.

Methods: Sixteen untrained women between 18 and 28 years participated in this cohort study, split equally between intervention and control groups. The intervention group trained for 8 weeks targeting improvements in posterior leg strength. Read More

World J Orthop 2017 Dec 18;8(12):935-945. Epub 2017 Dec 18.

Department of Orthopedics, Trauma Surgery and Sports Medicine, Johanna Etienne Hospital, Neuss 41462, Germany.

Aim: To evaluate our modified deepening trochleoplasty combined with a balanced medial patellofemoral ligament (MPFL) reconstruction for soft tissue alignement.

Methods: Thirty-three knees with with recurrent patellar dislocations and a trochlear dysplasia in 30 patients (m/f = 12/21, mean age 24 ± 9 years) underwent a combination of a modified deepening trochleoplasty and a balanced MPFL reconstruction for a medial soft tissue alignement. After a mean follow-up period of 29 ± 23 mo, patients' return to sports, possible complications as well as the clinical outcomes using the Kujala, International Knee Documentation Committee (IKDC) and Lysholm scoring were evaluated. Read More

Oper Orthop Traumatol 2017 Dec 25;29(6):509-519. Epub 2017 Oct 25.

Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland.

Objective: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol.

Indications: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm. Read More

Arthroplast Today 2017 Mar 4;3(1):25-28. Epub 2016 Nov 4.

Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.

Prolonged dislocation of the patella is a rare condition and is often related to severe osteoarthritis (OA) of the femorotibial (FT) joint. For this condition's treatment, numerous surgical techniques using total knee arthroplasty (TKA) have been published. To the best of our knowledge, this case report is the first description of the use of lateral release alone to treat recurrent patellar subluxation with TKA. Read More

Pediatr Radiol 2016 May 9;46(5):618-36. Epub 2016 Feb 9.

Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Transient patellar dislocation is a common entity in children and adolescents, characterized by lateral dislocation of the patella, usually with spontaneous reduction. Many predisposing conditions have been described, including trochlear dysplasia, excessive lateral patellar tilt, patella alta and lateralization of the tibial tuberosity. Associated injuries are bone bruises of the patella and lateral femoral condyle, tears of the medial retinaculum that include the medial patellofemoral ligament (MPFL), tears of the vastus medialis obliquus muscle, injuries of articular cartilage, and intra-articular bodies. Read More

GMS Interdiscip Plast Reconstr Surg DGPW 2016 18;5:Doc01. Epub 2016 Jan 18.

Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Germany.

Fractures of the patella account for about 1% of all skeletal injuries and can lead to profound impairment due to its crucial function in the extensor mechanism of the knee. Diagnosis is based on the injury mechanism, physical examination and radiological findings. While the clinical diagnosis is often distinct, there are numerous treatment options available. Read More

Singapore Med J 2015 Oct;56(10):542-7; quiz 548

Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

A 14-year-old girl presented with left knee pain and swelling after an injury. Magnetic resonance (MR) imaging showed a transient lateral patellar dislocation with patellar osteochondral fracture, medial patellofemoral ligament tear and underlying femoral trochlear dysplasia. Open reduction and internal fixation of the osteochondral fracture, plication of the medial patellar retinaculum and lateral release were performed. Read More

J Orthop Surg Res 2015 Aug 19;10:126. Epub 2015 Aug 19.

Gelenk Klinik, Gundelfingen, Freiburg, Germany.

Background: Patellar stabilizing braces are used to alleviate pain and prevent subluxation/dislocation by having biomechanical effects in terms of improved patellar tracking. The purpose of this study is to analyze the effects of the dynamic patellar realignment brace, Patella Pro (Otto Bock GmbH, Duderstadt, Germany), on disease determinants in subjects with patellofemoral instability using upright weight-bearing magnetic resonance imaging (MRI).

Methods: Twenty subjects (8 males and 12 females) with lateral patellofemoral instability were studied in an open-configuration magnetic resonance imaging scanner in an upright weight-bearing position at full extension (0° flexion) and 15° and 30° flexion with and without the realignment brace. Read More

Am J Orthop (Belle Mead NJ) 2015 Jul;44(7):299-301

Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.

Patellar dislocations often spontaneously reduce or are reduced easily by experienced professionals. However, some dislocations can prove difficult to reduce and may require sedation or operative management. Our case report suggests an alternative method to facilitate reduction of patellar dislocations. Read More

Arch Pediatr 2015 Aug 2;22(8):830-9. Epub 2015 Jul 2.

Service de chirurgie orthopédique et traumatologique, CHU Habib-Bourguiba, 3029 Sfax, Tunisie; Faculté de médecine de Sfax, Sfax, Tunisie.

Introduction: Arthrogryposis is a condition existing at birth, seen in different diseases that have in common the existence of multiple joint stiffness. The clinical presentation is diversified and the functional prognosis depends on the etiology, which makes therapeutic options different from one case to another. The objective of this study was to describe clinical manifestations observed in arthrogrypotic patients and show the different therapeutic methods and functional results. Read More

Am J Orthop (Belle Mead NJ) 2015 Jun;44(6):E195-8

Department of Orthopaedics, Rutgers University-New Jersey Medical School, Newark, NJ.

Since 1887, approximately 50 cases of an intra-articular patellar dislocation have been reported in the worldwide literature. The vast majority of patients required an open reduction of the patella or closed reduction under general anesthesia. This injury has never been reported in association with a coronal shear fracture of the femoral condyle. Read More

Knee 2015 Dec 26;22(6):580-4. Epub 2015 May 26.

Laboratory of Exercise Physiology (LPE EA 4338), Lyon University, Saint-Etienne, France; Department of Orthopaedic Surgery, University Hospital Center of Saint-Etienne, France.

Background: The medial patellofemoral ligament (MPFL) is the most commonly injured structure in patients with objective patellar instability. The objective of this study was to prospectively evaluate the clinical and radiographic results of MPFL reconstruction in 50 patients with chronic patellar instability.

Methods: Fifty patients with chronic patellar instability, aged 15-39 years, were included. Read More

Case Rep Orthop 2015 25;2015:328386. Epub 2015 Mar 25.

Trauma and Orthopaedic Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hill Road, Cambridge CB2 0QQ, UK.

A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a "dorsal fin" appearance of the soft tissues tented over the patella. Read More

Cochrane Database Syst Rev 2015 Feb 26(2):CD008106. Epub 2015 Feb 26.

Faculty of Medicine and Health Sciences, University of East Anglia, Queen's Building, Norwich, Norfolk, UK, NR4 7TJ.

Background: Patellar dislocation occurs when the patella disengages completely from the trochlear (femoral) groove. Following reduction of the dislocation, conservative (non-surgical) rehabilitation with physiotherapy may be used. Since recurrence of dislocation is common, some surgeons have advocated surgical intervention rather than non-surgical interventions. Read More

J Knee Surg 2015 Aug 29;28(4):303-9. Epub 2015 Jan 29.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Read More

Knee Surg Sports Traumatol Arthrosc 2016 Jan 11;24(1):247-53. Epub 2014 Oct 11.

Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.

Purpose: This animal study aimed to investigate whether early reduction in patellar subluxation could minimize femoral trochlear dysplasia in growing rabbits.

Methods: Sixty rabbits were divided into four groups (N = 30 knees/group). The control group underwent no surgical procedures. Read More

Sports Health 2014 May;6(3):246-55

Washington University in Saint Louis, Saint Louis, Missouri.

Context: Sideline management of sports-related joint dislocations often places the treating medical professional in a challenging position. These injuries frequently require prompt evaluation, diagnosis, reduction, and postreduction management before they can be evaluated at a medical facility. Our objective is to review the mechanism, evaluation, reduction, and postreduction management of sports-related dislocations to the shoulder, elbow, finger, knee, patella, and ankle joints. Read More

F1000Res 2014 22;3:22. Epub 2014 Jan 22.

Department of Orthopaedics, Government Medical College, Kozhikode, 673008, India.

Background: Congenital dislocation of the radial head of the elbow is rare. It is genetically transmitted in some cases and is often associated with syndromes, such as Nail-Patella syndrome, antecubital pterygium and ulnar dysplasia. About two thirds are posterior, with the remainder being either anterior (15%) or lateral (15%). Read More

J Orthop Surg (Hong Kong) 2013 Dec;21(3):281-4

Department of Orthopaedic Surgery, National University Hospital, Singapore.

Purpose: To compare the outcome of bicompartmental knee arthroplasty (BKA) versus total knee arthroplasty (TKA) in patients with medial and patellofemoral knee osteoarthritis.

Methods: Records of 17 women and 10 men with medial and patellofemoral osteoarthritis of the knee who underwent BKA (n=15) or TKA (n=12) were reviewed. All surgeries were performed by the same surgeon. Read More

J Pediatr Orthop B 2014 Mar;23(2):126-9

Departments of aKnee Surgery bOrthopedics Surgery, Firouzgar Hospital cDepartment of Pediatrics, Emam Khomeimi Hospital, School of Medicine, Tehran University of Medical Science, Tehran, Iran.

Lateral dislocation of the patella is reported frequently in orthopaedics references but congenital medial patellar dislocation is reported rarely. An 8-year-old girl was referred to our department for knee surgery. She had genuvarum, knee flexion contracture and tibial internal rotation. Read More

Knee Surg Sports Traumatol Arthrosc 2014 Oct 7;22(10):2491-8. Epub 2013 Nov 7.

Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica, ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136, Bologna, Italy,

Purpose: To evaluate mid-term clinical and radiographic outcomes after an original medial patellotibial ligament reconstruction in patients with patellar dislocation.

Methods: Twenty-nine knees (27 patients, 8 males and 19 females) treated for patellar dislocation with medialization of the patellar tendon medial third combined with medial and lateral release were evaluated clinically and radiographically at a mean follow-up of 6.1±2. Read More

Am J Sports Med 2013 Sep 7;41(9):2128-35. Epub 2013 Aug 7.

Department for Trauma Surgery and Orthopaedic Surgery, Krankenhaus Landshut-Achdorf, Landshut, Germany.

Background: Persistent pain and redislocations after surgical treatment of patellofemoral instability are described in up to 40% of patients. However, prospective outcome data about revision surgery are missing.

Purpose: To evaluate the clinical outcome after revision medial patellofemoral ligament (MPFL) reconstruction using isolated and combined procedures, with a follow-up of 24 months. Read More

Knee Surg Sports Traumatol Arthrosc 2014 Nov 14;22(11):2591-8. Epub 2013 Jul 14.

Department of Orthopedic Sports Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany,

Purpose: Excessive trochlear dysplasia may be responsible for recurrent patellofemoral instability (PFI) due to a missing bony guidance for the patella in early flexion. Thus, an isolated medial patellofemoral ligament reconstruction (MPFLR) can be insufficient, since it mainly addresses instability close to extension and additionally can increase patellofemoral pressure leading to pain in flat or convex trochlear dysplasia. Therefore, in combination with a trochleoplasty, an anatomical trochlear groove is created, resulting in patellofemoral stability also in flexion, while patellofemoral pressure is normalized. Read More

Am J Sports Med 2013 Mar 22;41(3):575-81. Epub 2013 Jan 22.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.

Background: Patellofemoral instability is common in the pediatric and adolescent population, yet prognosis after the first dislocation has been difficult to determine.

Purpose: To describe the demographics of pediatric and adolescent patients with a first-time patellofemoral dislocation and to determine predictors of recurrent instability.

Study Design: Case-control study; Level of evidence, 3. Read More

Knee 2014 Mar 8;21(2):589-93. Epub 2013 Jan 8.

Department of Orthopaedic Surgery, Keio University, School of Medicine, Japan.

We present a case of an 8-year-old boy diagnosed with melorheostosis who was suffering from severe genu valgum, permanent dislocation of the patella, knee flexion contracture and leg length shortening. Soft tissue contracture of the limb and subsequent joint deformities were reported to represent clinical manifestations of pediatric melorheostosis. As the epiphyseal plate had not closed, patellar reduction was achieved by soft tissue surgical stabilization, including lateral retinacular release, medial retinaculum plication, and transfer of the lateral half of the patellar tendon. Read More

J Emerg Med 2013 Apr 29;44(4):760-3. Epub 2012 Nov 29.

Department of Emergency Medicine, Cleveland Clinic Florida, Weston, FL 33331, USA.

Background: Patellar dislocations are a commonly treated injury in the Emergency Department (ED), with a majority of cases involving lateral subluxation of the patella outside of the joint space. Intra-condylar dislocations of the patella are rare. Of the two types of axis rotation, vertical and horizontal, the vertical occurs five times less frequently. Read More

Rev Esp Cir Ortop Traumatol 2012 Jan-Feb;56(1):63-6. Epub 2011 Dec 20.

Servicio de Ortopedia y Traumatología Pediátricas, Hospital Sant Joan de Déu, Barcelona, España.

Patellar osteochondral fractures with no dislocation are uncommon and usually affect the centromedial facet of the patella. We present the case of a 10 year-old, overweight, female patient. She was seen in the emergency room after suffering an accidental fall, assessed as an osteochondral fracture-dislocation of the right patella with upper-outer displaced free fragments. Read More

Knee 2014 Mar 14;21(2):582-5. Epub 2012 Nov 14.

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address:

Traumatic knee joint dislocations are relatively rare. Most of knee dislocations are reduced by closed manipulation. However occasionally, especially in the case of soft tissue incarceration, closed reduction may not be possible and open reduction is mandatory. Read More

Orthopedics 2012 Aug;35(8):e1267-71

Department of Surgery, Division of Orthopaedic Surgery, A.T. Still University of Health Sciences, Kirksville, MO 63501, USA.

Osteochondral fracture of the patella following a lateral patellar dislocation can be treated with operative and nonoperative techniques that are dictated by the clinical presentation. In the presence of large fragments following acute fractures, arthroscopic retrieval and fixation are advocated, whereas smaller displaced fragments may be removed and discarded as loose bodies. Several methods of fixation exist for osteochondral fractures of the patella, including the use of cannulated and noncannulated screws. Read More

J Pediatr Orthop B 2013 Jul;22(4):329-32

Department of Orthopaedic Surgery, Division of Sports Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.

Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. Read More

Adv Orthop 2012 14;2012:249687. Epub 2012 Jun 14.

1st Department of Orthopaedic Surgery, P. & A. Kyriakou Children's Hospital, Athens, Greece.

A retrospective study was performed on the use of bioabsorbable pins in the fixation of osteochondral fractures (OCFs) after traumatic patellar dislocation in children. Eighteen children (13 females, 5 males) aged 11 to 15 years (mean age 13.1 years) with osteochondral fracture (OCF) of the knee joint were treated at the authors' institution. Read More

Knee 2012 Oct 15;19(5):713-5. Epub 2012 Mar 15.

The Catholic University of Korea, Department of Orthopaedic Surgery, Daejeon, Republic of Korea.

Acute patellar dislocation is a severe injury to the knee and usually manifests with symptoms such as giving way, a sensation of lateral displacement of the patella accompanied by hemarthrosis and tenderness over the medial epicondylar region to palpation. Spontaneous reduction of the patella makes the diagnosis more difficult in initial evaluation. Radiographs often show a small bony avulsion at the medial border of the patella, which may represent an injury to the medial restraints. Read More

Am J Sports Med 2012 Feb 22;40(2):346-51. Epub 2011 Nov 22.

Department of Orthopedic Surgery, Hôpital de la Croix-Rousse, Centre Albert Trillat, Lyon, France.

Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Additionally, increased patellar tendon length may allow pathologically increased coronal plane patellar motion. Read More