Closed-wedge Patelloplasty for the Treatment of Distal Patellofemoral Maltracking and Instability due to Severe Patellar Dysplasia: Case Report and Surgical Technique
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Closed-wedge Patelloplasty for the Treatment of Distal Patellofemoral Maltracking and Instability due to Severe Patellar Dysplasia: Case Report and Surgical Technique. / Frings, Jannik; Freudenthaler, Fabian; Krause, Matthias; Frosch, Karl-Heinz.
In: STRATEG TRAUMA LIMB, Vol. 15, No. 3, 2020, p. 184-192.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Closed-wedge Patelloplasty for the Treatment of Distal Patellofemoral Maltracking and Instability due to Severe Patellar Dysplasia: Case Report and Surgical Technique
AU - Frings, Jannik
AU - Freudenthaler, Fabian
AU - Krause, Matthias
AU - Frosch, Karl-Heinz
N1 - Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.
PY - 2020
Y1 - 2020
N2 - Background: Patellofemoral maltracking is caused by different anatomical factors. Most of them are associated with a proximal maltracking, which alters the patella's engagement into the trochlear groove and predisposes the patellofemoral joint for instability. Different surgical techniques have been described to realign patellar tracking, however, most of which address proximal patellar maltracking.Aim: The aim of this article is to demonstrate the influence of patella-related deformities on patellar tracking and to present a novel surgical technique for the treatment of distal patellar maltracking, caused by a severe patellar dyplasia.Case Description: We report the case of a 23-year-old patient with a severe patellar dysplasia, presenting a distal patellar maltracking with recurring dislocations in deep flexion. Due to her instability, the patient was immobilised and dependent on the constant use of walking aids. Radiological images showed a concavely shaped patellar, which articulated exclusively with the lateral epicondyle and caused the patella to dislocate laterally, starting at a flexion angle of 60°. An anterior closing-wedge osteotomy was used to reshape and recenter the patella, which was complemented by a medial patellofemoral ligament reconstruction. At the 18-month follow-up, the patient presented pain free and fully remobilised, without the use of walking aids. Patellar tracking was reestablished, with a possible knee flexion until 140°. No redislocation of the patella had occurred.Conclusion: Distal patellofemoral maltracking, caused by a severe patellar dysplasia, can successfully be treated with an anterior closed-wedge osteotomy of the patella. In combination with a medial patellofemoral ligament reconstruction, patellofemoral stability can be reestablished, to prevent further dislocations.Clinical Significance: There are multiple factors, which may cause patellar maltracking. A thorough clinical and radiological preoperative analysis is mandatory, in order to clearly identify the underlying pathologies, as these may affect patellar tracking proximally or distally.How to cite this article: Frings J, Freudenthaler F, Krause M, et al. Closed-wedge Patelloplasty for the Treatment of Distal Patellofemoral Maltracking and Instability due to Severe Patellar Dysplasia: Case Report and Surgical Technique. Strategies Trauma Limb Reconstr 2020;15(3):184-192.
AB - Background: Patellofemoral maltracking is caused by different anatomical factors. Most of them are associated with a proximal maltracking, which alters the patella's engagement into the trochlear groove and predisposes the patellofemoral joint for instability. Different surgical techniques have been described to realign patellar tracking, however, most of which address proximal patellar maltracking.Aim: The aim of this article is to demonstrate the influence of patella-related deformities on patellar tracking and to present a novel surgical technique for the treatment of distal patellar maltracking, caused by a severe patellar dyplasia.Case Description: We report the case of a 23-year-old patient with a severe patellar dysplasia, presenting a distal patellar maltracking with recurring dislocations in deep flexion. Due to her instability, the patient was immobilised and dependent on the constant use of walking aids. Radiological images showed a concavely shaped patellar, which articulated exclusively with the lateral epicondyle and caused the patella to dislocate laterally, starting at a flexion angle of 60°. An anterior closing-wedge osteotomy was used to reshape and recenter the patella, which was complemented by a medial patellofemoral ligament reconstruction. At the 18-month follow-up, the patient presented pain free and fully remobilised, without the use of walking aids. Patellar tracking was reestablished, with a possible knee flexion until 140°. No redislocation of the patella had occurred.Conclusion: Distal patellofemoral maltracking, caused by a severe patellar dysplasia, can successfully be treated with an anterior closed-wedge osteotomy of the patella. In combination with a medial patellofemoral ligament reconstruction, patellofemoral stability can be reestablished, to prevent further dislocations.Clinical Significance: There are multiple factors, which may cause patellar maltracking. A thorough clinical and radiological preoperative analysis is mandatory, in order to clearly identify the underlying pathologies, as these may affect patellar tracking proximally or distally.How to cite this article: Frings J, Freudenthaler F, Krause M, et al. Closed-wedge Patelloplasty for the Treatment of Distal Patellofemoral Maltracking and Instability due to Severe Patellar Dysplasia: Case Report and Surgical Technique. Strategies Trauma Limb Reconstr 2020;15(3):184-192.
U2 - 10.5005/jp-journals-10080-1501
DO - 10.5005/jp-journals-10080-1501
M3 - SCORING: Journal article
C2 - 34025801
VL - 15
SP - 184
EP - 192
JO - STRATEG TRAUMA LIMB
JF - STRATEG TRAUMA LIMB
SN - 1828-8928
IS - 3
ER -