Treatment of patellar dislocation of different etiology combined with accompanying pathology

Purpose. To analyze the results of treating patellar dislocation combined with accompanying deformities of distal femur and the knee contractures. Materials and Methods. The results of surgical treatment analyzed in 15 patients (16 knee joints) with patellar dislocation of different etiology and severity combined with deformities of distal femur and contractures of the knee. The tendinous-and-ligamentous apparatus dissected from the outside and fastened from the inner side of the patella for dislocation of mild severity. As for dislocation of severe degree, the technique of reconstructing the knee extension system was used with the patellar ligament transfer medially. The patellar dislocation of mild degree and, in six cases, that of severe degree has been eliminated with simultaneous deformity correction by performing supracondylar osteotomy, as well as femoral, patellar, and leg fixation with the Ilizarov fixator. Supracondylar osteotomy performed at first in two patients with severe dislocation to correct accompanying deformities, and patellar dislocation eliminated at a stage. The dislocation was corrected in one female patient, and supracondylar osteotomy performed with acute elimination of valgus deformity followed by further gradual correction of the knee flexion contracture. Results. Normal biomechanical axis was recovered, and patellar dislocation eliminated in all the patients. Conclusion. The use of the proposed techniques allows solving the posed clinical problems and improving patients’ quality of life.