Resulted outcome of proximal and distal realignment in patients with patellar subluxation and dislocation

Background: Anterior knee pain is a common complaint in orthopedic patients, and patellar
malalignment is a fragment cause of this alignment. Severe malalignment would result
insubluxation and dislocation of patella: the result of surgical treatment with proximal and distal
realignment (P/DR) for such pathology, performed in Sadoghee and Al-Zahra hospital (in Isfahan)
from 1994 to 1999 is reported in this article.
Materials and Methods: A retrospective study of 26 cases, 4 male and 22 female patients, with
average age of 28 years. which had patellar instability and had undergone P/D-R during a five year
period (1944-1999) in two of the hospital in Isfahan, was performed. These cases had all failed the
initial conservative treatment. The cases were follow-up for a period of 3.5 years. Results of
surgery were canalized in term of subjective relief of symptoms, and objective evaluation of
quadriceps power, knee motion, as well as radiographic signs of knee degeneration, patellar
subluxation, patella alta or patella infra.
Results: 30 knees had received the index operation – 16 (53%) right and 14 (47%) left side. The
result of surgery was good in 28 (94%) and poor in 2 knees. 20 patients (71%) had normal
radiographs, 5 cases (18%) had evidence of mild and 2 cases severe degeneration. Patellar intra
was also observed in one knee.
Conclusions: proximal and distal realignment surgery for cases that suffer from patellar
instability and are non-responsive to conservative treatment is associated with high rate of success
without serious complication.