MEDIUM-TERM RESULTS OF THE OPERATIVE TREA TMENT OF PATELLAR DISLOCATION BY THE INSALL METHOD OF PROXIMAL REALIGNMENT

Between 1984 and 1991, 57 patients with diagnosis of an acute or recur rent patellar dislocation were treated operatively using proximal real ignment with vastus medialis transfer and lateral release (Insall oper ation). a total of 45 patients (15 with acute and 30 with recurrent pa tellar dislocation) were reviewed at an average follow-up of 6.5 years (2-9.6 years). The average age at injury was 21.5 years, with a predo minance of female patients. Follow-up examination included routine kne e examination, clinical review using the modified knee scoring scale o f Larsen and Lauridsen, sports activity level and subjective satisfact ion. Radiographics from 27 patients (60 %) were evaluated. One patient from each group suffered recurrence of patellar dislocation. All pati ents had stable knee joints and a full range of motion. There was no s tatistical difference in the pre- and postoperative sports activity le vel in both groups. Three patients (19.9 %) with acute patellar disloc ation and seven patients (23.3 %) with recurrent patella dislocation h ad excellent results using the Larsen and Lauridsen score scale. Ten p atients (66.6 %) with acute and 12 (39.9 %) with recurrent dislocation had good results. One patient with recurrent patellar dislocation had a fair result. Subjective evaluation revealed the operative result in 93 % of cases as very good, good or satisfactory. Patellofemoral oste oarthritis was seen in 11 (40.7 %) of 27 patients. Our results show go od clinical results for the treatment of acute patellar dislocation in young, active patients with the proximal realignment procedure. The r ecurrence rate of patellar dislocation can be reduced for acute and re current patellar dislocation. Subjective satisfaction with this proced ure is rated very good.