Abstract
Patella instability can be a disabling condition predominately affecting younger patients, restricting activity and potentially leading to premature osteoarthritis. We describe and evaluate a new technique of stabilising the joint.
Between November 2000 and January 2002 we operated on 24 unstable knees (belonging to 23 patients). All patients had failed a course of conservative treatment and the average number of dislocations pre-operatively was 7. All patients had an extra-synovial lateral release and stabilisation by harvesting the semitendinosus tendon which was then tunnelled through a vertical hole in the patella, under the vastus medialis, wrapped around the adductor magnus and tied to itself at the lower border of the patella.
The patients were assessed clinically and radiologically at an average of 19 months, following the procedure.
There were 19 knees assessed: 13 female /6 male, 10 left /9 right, average age 22 years. 13 patients had retro-patella chondral damage none had meniscal or cruciate pathology. The visual analogue score increased from 4 pre-op to 7.5 after operation. The Kujala patello-femoral score was 74 post procedure. 53% of patients described their knee as excellent, 47% as good. Only one patient has re-dislocated to date (single event). There were no specific risk factors.
Conclusion: Stabilisation of an unstable patello-femoral joint with a semitendinosus loop is a highly successful procedure with good patient satisfaction. We are also happy to use this procedure in the skeletally immature as its use does not preclude a later realignment procedure, should it be indicated.
The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom
