instability

Background

Definition

Dislocated Patella

 

Repeated dislocation of patella with minimal trauma

- 15-20% of paediatric acute patella dislocations

- more common girls 

- often bilateral

 

Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion 

 

Direction

 

Management

Non-operativePatella Instability MPFL and TTT AP

 

Results

 

90% respond 

- very important

- 6 - 12 months minimum before offering surgery

 

Physiotherapy

 

1.  Stretches

- quads stretches

- ITB

- lateral retinaculum

 

Latarjet / Bristow

Bristow

 

Concept

 

Non-anatomical bony block 

- transfer of coracoid process through subscapularis

- dynamic anteroinferior musculotendinous sling

- provides subscapularis tenodesis

- preventing lower portion from displacing proximally as arm abducted

- when shoulder in vulnerable position abduction and ER