[Current aspects of surgical management of patellar dislocation in the growth period with special reference to Goldthwait surgery].

RESEARCH QUESTION

The Goldthwait procedure is an operative treatment method for patellar dislocation in children which respects the growth plate. The aim of the study was to analyse the long term results of this procedure.

METHODS

The results of 36 knees (26 children) operated on because of patellar dislocation according to the Goldthwait technique alone or in combination with other procedures (Krogius, patellar fixation) between 1941-1991 at Balgrist Clinic were analysed. Therefore, we used an own score.

RESULTS

After a mean follow-up of 16 years (1.5 to 51 years) we found in 77.8% of the cases good and very good subjective results, and in 63.9% good and very good objective results. A recurrence of dislocation occurred in 36.1% of the cases. In 76.9% of these cases a reoperation was performed, of which only one case led to an acceptable final result. The operation results were unsatisfactory in the presence of condylar dysplasia with an angle of more than 160 degrees. The age at the time of surgery and the degree of patellar dysplasia had no effect on the outcome. The success was increased through the use of the Goldthwait procedure in conjunction with other techniques. Pathologic leg axis or severe arthrosis did not occur.

CONCLUSION

In absence of significant condylar dysplasia the Goldthwait procedure combined with other techniques provides acceptable results. The technique alone is less efficient.