Irreducible Acute Patellar Dislocation due to a New Anatomical Variant - the Notched Patella

Revista Brasileira De Ortopedia
Miguel Duarte-SilvaFrancisco Guerra-Pinto

Abstract

Irreducible patella dislocations are rare and are usually associated with complex mechanisms. The authors report the clinical case of an irreducible lateral patellar dislocation due to an anatomical variant. The authors assisted a 16-year-old patient who presented with a lateral patella dislocation that was impossible to reduce by closed manipulation, even under general anesthesia. During the imaging study, the computed tomography (CT) exam showed a notch in the medial facet of the patella, impacted in the lateral condyle, which prevented the reduction. This anatomical variant was later confirmed during surgery. In a bilateral follow-up CT, this variant was also present in the contralateral, normal knee, excluding traumatic reshaping as the reason for this patellar notch. The authors used a medial parapatellar approach for open reduction of the dislocation and to repair the medial retinaculum. According to Wiberg, there are three different patella types. The authors describe a variation of type III patella with a notch in the medial border that is not included in the previous classification. They emphasize the importance of a CT study in the presence of an irreducible dislocation and the recognition of this anatomical variant o...Continue Reading

References

Jan 1, 1994·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·H DejourC Guier
Dec 15, 2010·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Alfredo Schiavone PanniPhilippe Neyret
Nov 20, 2012·Indian Journal of Orthopaedics·Rakesh Kumar GuptaPradeep Kamboj
Jan 1, 2012·Journal of Surgical Case Reports·M LoweK Tetsworth
Oct 10, 2014·Indian Journal of Orthopaedics·Prasad C SoraganviAshok S Gavaskar

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