Arthroscopic Lateral Release With Medial Retinacular Plication After Patellar Dislocation In Adolescents With And Without Generalised Ligamentous Laxity

Objective:This study was undertaken to evaluate the influence of Generalised Ligamentous Laxityon clinical outcomes of arthroscopic Lateral Release With Medial Retinacular PlicationAfter Patellar Dislocation In Adolescents.Methods:Between September2004and September2011,37adolescent patients with recurrentpatellar dislocation underwent arthroscopic Lateral Release With Medial RetinacularPlication, and34of them completed the final follow-up and were enrolled.Inclusioncriteria for this study included an lateral release with medial retinacular placation.Generalised ligamentous laxity was diagnosed by the criteria of Carter andSweetnam(1958).And patients were were separated into group I (generalised ligamentouslaxity) and group II (non-generalised ligamentous laxity).And the group I included6malesand12females with an average age of14.2±2.1years (range,11-19years). The dislocationduration was7to39months with an average of14months. All patients experienced3-7episodes of dislocation.And the group II included6males and12females with an averageage of13.5±1.8years (range,8-17years). The dislocation duration was8to40months withan average of13months. All patients experienced2-5episodes of dislocation. All thepatients take the positive apprehension test,the degree of lateral patellar translation and thehardness termination in lateral translation of the patellar before and after the operation. Allthe patients need to take the X-Ray text to evaluate the position of the patella. Kneefunction was evaluated before and after operation according to the International KneeDocumentation Committee (IKDC), Kujala, Lysholm rating scales.Results: The final follow-up time of the two groups were46.9±18.7months（range,15～63months） and43.5±17.4months （range,13～58months）. Among the clinicalexamnation, The group I had significantly better clinical results compared with the group II.The IKDC, Lysholm and Kujala scores were62.5±6.2,70.7±5.1and76.6±4.8,respectively, in group I, and71.8±7.1(P<.001),79.4±5.5(P<.001) and82.9±4.8(P<.001), respectively, in group II at the final follow-up. Four patients (22.2%) in group Iand2patients (12.5%) in group II (P=.354) experienced episodes of redislocation at thefinal follow-up.Conclusions:Arthroscopic lateral release with medial retinacular plication is an effective techniqueby which patellofemoral instability can be addressed when non generalised ligamentouslaxity is present. In patients with generalised ligamentous laxity, patellofemoral stabilitycannot be completely restored, and clinical results are less successful. Precise preoperativeradiologic determination of generalised ligamentous laxity may help the clinician to predictshort-term outcomes in patients with patellofemoral instability.