نتايج جراحي در رفتگي مكرر و نيمه دررفتگي كشكك با اصلاح راستا از بالا و پايين كشكك

Proximal and Distal re-alignment Surgery for Patellar Subluxation and Dislocation (A Surveiy in Esfahan)

Background: Anterior knee pain is a common complaint in orthopaedic Patients, and patellar malaignment is a fragment cause of this ailment. Severe malaignment would result into subluxation and dislocation of patella: The result of surgical treatment with proximal and distal realignment (PID-R) for such a pathology, performed in sadoghee and Al-Zahra hospitals (in Esfahan) from 1994 to 1999 is reported in this orticle. Materials and Methods: A cross-sectional study of 26 cases, who had patellar instability and had undergone PID-R during a five year period (1944-1999) in two of the hospital in Esfahan, was performed. These cases had all failed the initial conservative treatment. The cases were evaluated after 2-7years. Results of surgery were analized in term of subjective relief of symptoms, and objective evaluation of quadriceps power, knee motion, as well as radiographic signs of knee degeneration, Patellar subluxation, Patella alta or intra. Results: There were 4 male and 22 female patients, with avarage age of 28 years. 30 knees had received the index operation - 16 (53%) right and 14 (47%) left side. The result of surgery was good in 28 (94%) and poor in 2 knees. 20 patients (71%) had normal radiographs, 5 cases (18%) had evidence of mild and 2 cases severe degeneration. Patellar intra was also observed in one knee. Conclusion: Proximal and distal realignment surgery for cases of patellar instability non-responsive to conservative treatment, is associated with high rate of success.