Gupta Arun, Sahu Dipit
Orthopaedic, Joint Replacement and Arthroscopy Clinic (OJAS) Clinic, Agra, India.
Department of Orthopaedic Surgery, Sir HN Reliance Foundation Hospital, Mumbai, India.
J ISAKOS. 2022 Feb;7(1):35-38. doi: 10.1016/j.jisako.2021.08.001. Epub 2021 Oct 5.
Medial dislocation of patella has been commonly reported as a complication of the surgical release of the lateral patella-femoral ligament. A traumatic medial eversion-dislocation of the patella has not been earlier reported. We report an unusual case of traumatic medial patellar eversion-dislocation in a young adult patient whose magnetic resonance imaging (MRI) showed a discontinuity in medial and lateral patellar retinacula. However, intraoperatively, the retinacula were found intact, and relocation of the patella was achieved by flipping the patella through a small hole in the patellar tendon. No reconstruction of the ligaments was needed. At 1-year follow-up, the patient achieved full range of movements of the knee, and there were no subjective complaints of instability. In our case, although the patella was medially everted and dislocated, both the retinacula were still intact. Clinicians should be aware that acute traumatic patella medial dislocation and eversion can occur without disruption of the medial or lateral retinaculum. Furthermore, knee MRI may suggest patellar retinacula disruption because of the retinaculum's obscure and tortuous course in patients with these injuries.
髌骨内侧脱位通常被报道为外侧髌股韧带手术松解的一种并发症。外伤性髌骨内侧外翻脱位此前尚未见报道。我们报告了一例年轻成年患者的外伤性髌骨内侧外翻脱位的罕见病例,其磁共振成像(MRI)显示髌内侧和髌外侧支持带连续性中断。然而,术中发现支持带完整,通过在髌腱上开一个小孔翻转髌骨实现了髌骨复位。无需韧带重建。随访1年时,患者膝关节活动范围完全恢复,无主观不稳定感。在我们的病例中,尽管髌骨发生了内侧外翻和脱位,但两侧支持带仍保持完整。临床医生应意识到,急性外伤性髌骨内侧脱位和外翻可在内外侧支持带未断裂的情况下发生。此外,膝关节MRI可能提示髌支持带断裂,因为在这些损伤患者中支持带走行模糊且曲折。