191 / 460
P.G. Ntagiopoulos, P. Byn, D. Dejour
190
shown in Table 3. Sulcus angle decreased
significantly (p<.01) from 153
o
±14° pre-
operatively to 141
o
±10° post-operatively, TT-
TG distance decreased significantly (p<.001)
from 16±6mm to 12±2mm and patellar tilt
without quadriceps contraction decreased
significantly (p<.0001) from 31
o
±14° to 11
o
±8°
(Table 2). Pain decreased in 72% of the cases,
remained unchanged or increased in 28% and
there was no case of post-operative stiffness.
Apprehension sign was negative post-
operatively in 75%, patellar tracking was
normal in all of the cases, lateral patellar
tracking was <1 quadrant in 72% and <2
quadrants in 28% of the knees. Mean pre-
operative IKDC score was 51.4±21.8 (23-75)
and at last follow-up it increased to 76.7±13.0
(53-100), (p<.001). At the time of final follow-
up, there was no case with patellofemoral
arthritis according to Iwano criteria and 95.4%
of the patients had returned to previous
activities, including recreational sports. None
of the patients had a patella dislocation
recurrence and no post-operatively feeling of
patellar instability. All of them responded that
they were satisfied from surgery. There were no
complications recorded in this group and there
was no re-operation.
Group B included 27 patients with 31 knees
that had more than 3 true episodes of patellar
dislocation and no previous surgery for
patellofemoral dislocation. Mean age was
21±7.9 years (14-47) at the time of surgery
with a female to male ratio of 0.93. Mean
follow-up was 7 years (2-9) and no patient was
lost to follow-up. Forty-five per cent had a
positive familiar history of recurrent patellar
dislocation and 14.8% had bilateral surgery.
Patients’ symptoms and clinical signs were
lateral patellar dislocation (100%), patello
femoral pain (6.4%), positive apprehension
sign (96.7%) and abnormal patellar tracking
(54.8%) (Table 1). Trochlear cartilage lesions
before surgery were: 67.7% had ICRS grade 0,
6.4% grade I, 16.2% grade II, 3.2% grade III,
6.5% grade IV, and for the patella 25.8% grade
0, 0% grade I, 19.2% grade II, 22.5% grade III,
Table 1: Patient demographics, clinical signs, symptoms and associated procedures for the two groups.
Group A
Group B
No. of knees
24
31
Age
23±5.5 years (14-33)
21±7.9 years (14-47)
Abnormal patellar tracking
81%
54.8%
Apprehension sign
91.6%
96.7%
Feeling of instability
100%
100%
Associated pain
12.5%
6.4%
Previous operations
Yes
No
Concomitant procedures
1. VMO plasty
41.6%
83.8%
2. MPFL reconstruction
45.8%
16.1%
3. Distal transfer of tibial tuberosity
20.8%
51.6%
4. Medial transfer of tibial tuberosity
29.1%
67.7%
5. Lateral retinaculum release
25%
67.7%
6. Patellar osteotomy
4.1%
0%
7. Patellar tendon lengthening
8.3%
0%