Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation - A review of eight cases

An open surgical repair of the injured medial patellar stabilizers, includi ng the vastus medialis obliquus muscle and the medial patellofemoral ligame nt, after acute patellar dislocation was studied in eight patients. At init ial examination, all patients had tenderness over the adductor tubercle and a positive patellar apprehension sign. Four of eight patients had obvious ecchymosis over the adductor tubercle. Magnetic resonance imaging, diagnost ic arthroscopy, and open surgical exploration documented injury to both the medial patellofemoral ligament and the origin of the vastus medialis obliq uus muscle. In all patients, the torn muscle was retracted in an anterior a nd superior direction and an arthroscopic lateral release was performed fol lowed by open primary repair of the medial patellofemoral ligament to the a dductor tubercle and repair of the vastus medialis obliquus muscle to the a dductor magnus tendon. Patients were evaluated postoperatively with the Kuj ala scoring questionnaire. The average follow-up was 3.0 years, with a mini mum of 1.5 years. No patients experienced a recurrent dislocation, The aver age Kujala score was 91.9. Patients rated their return to athletic activity at an average 86% of their preinjury level. The average subjective satisfa ction was 96%. In appropriate cases of acute patellar dislocation, we recom mend primary repair of the medial patellofemoral ligament and the vastus me dialis obliquus muscle to avoid recurrent dislocation, chronic subluxation, pain, and disability.