Redirection Quadricepsplasty as a Salvage Procedure for Recurrent Habitual Dislocation of Patella with Vastus Lateralis Fibrosis - Report of an Innovative Technique and Four Case Studies

Redirection Quadricepsplasty as a Salvage Procedure for Recurrent Habitual Dislocation of Patella with Vastus Lateralis Fibrosis - Report of an Innovative Technique and Four Case Studies

Painless habitual dislocation of the patella (HDP) is a condition whereby a patella is insecurely held in the intercondylar groove during ordinary movement of knee joint. The condition is either congenital or acquired. Surgical intervention is recommended but recurrent dislocation of patella is not uncommon. This study reports a novel surgical treatment as salvage and the clinical short-term outcome for HDP secondary to vastus lateralis (VL) fibrosis.
From 2002 to 2008, the authors successfully treated seven failed cases of HDP following soft tissue release using an innovative procedure called redirection quadricepsplasty, which consists of lateral release, medial redirection of the extensor mechanism, optional V-Y lengthening and medial plication. Intramuscular injection-related vastus lateralis fibrosis, instead of congenital origin, was proven to be the cause of HDP in all cases. There was no recurrence of dislocation following redirection quadricepsplasty in all cases.
This study reports on the technique and surgical outcome. The patients were followed to an average of 45 months (range 24-63) and showed satisfactory functional results and full active range of motion. Redirection quadricepsplasty is a feasible optional salvage procedure after failed surgery or for failed cases of HDP after primary surgery.