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Anatomy of Patellar Dislocation

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Book cover Anterior Knee Pain and Patellar Instability

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Abstract

Acute patellar dislocation is a common injury that can lead to disabling knee pain and/or recurrent instability. In the past 10 years, research has begun to focus on the injuries associated with acute patellar dislocation, and the specific contributions the injured structures make to patellar stability in intact knees. The implication is that injury to specific structures may have important consequences in converting a previously asymptomatic, though perhaps abnormal, patellofemoral joint into one that is painful and/or unstable. These studies have been intended to improve the precision of surgical treatment for patellar instability, and their results are driving refinements in our surgical indications as well as technique.

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References

  1. Nietosvaara, Y, K Aalto, and PE Kallio. Acute patellar dislocation in children: incidence and associated osteochondral fractures. J Pediatr Orthop 1994; 14(4): 513–515.

    CAS  PubMed  Google Scholar 

  2. Atkin, DM, DC Fithian, KS Marangi et al. Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury [in process citation]. Am J Sports Med 2000; 28(4): 472–479.

    CAS  PubMed  Google Scholar 

  3. Levy, AS, MJ Wetzler, M Lewars et al. Knee injuries in women collegiate rugby players. Am J Sports Med 1997; 25(3): 360–362.

    CAS  PubMed  Google Scholar 

  4. Cofield, RH, and RS Bryan. Acute dislocation of the patella: Results of conservative treatment. J Trauma 1977; 17(7): 526–531.

    CAS  PubMed  Google Scholar 

  5. Hawkins, RJ, RH Bell, and G Anisette. Acute patellar dislocations: The natural history. Am J Sports Med 1986; 14(2): 117–120.

    CAS  PubMed  Google Scholar 

  6. Maenpaa, H, H Huhtala, and MU Lehto. Recurrence after patellar dislocation. Redislocation in 37/75 patients followed for 6–24 years. Acta Orthop Scand 1997; 68(5): 424–426.

    CAS  PubMed  Google Scholar 

  7. Dandy, DJ. Recurrent subluxation of the patella on extension of the knee. J Bone Joint Surg [Br] 1971; 53(3): 483–487.

    CAS  Google Scholar 

  8. Hughston, JC. Subluxation of the patella. J Bone Joint Surg [Am] 1968; 50(5): 1003–1026.

    CAS  PubMed  Google Scholar 

  9. Madigan, R, HA Wissinger, and WF Donaldson. Preliminary experience with a method of quadricep-splasty in recurrent subluxation of the patella. J Bone Joint Surg [Am] 1975; 57(5): 600–607.

    CAS  PubMed  Google Scholar 

  10. Maenpaa, H, and MU Lehto. Surgery in acute patellar dislocation: Evaluation of the effect of injury mechanism and family occurrence on the outcome of treatment. Br J Sports Med 1995; 29(4): 239–241.

    CAS  PubMed  Google Scholar 

  11. Nikku, R, Y Nietosvaara, PE Kallio et al. Operative versus closed treatment of primary dislocation of the patella: Similar 2-year results in 125 randomized patients [see comments]. Acta Orthop Scand 1997; 68(5): 419–423.

    CAS  PubMed  Google Scholar 

  12. Arnbjornsson, A, N Egund, O Rydling et al. The natural history of recurrent dislocation of the patella: Long-term results of conservative and operative treatment. J Bone Joint Surg [Br] 1992; 74(1): 140–142.

    CAS  Google Scholar 

  13. Crosby, EB, and J Insall. Recurrent dislocation of the patella: Relation of treatment to osteoarthritis. J Bone Joint Surg [Am] 1976; 58(1): 9–13.

    CAS  PubMed  Google Scholar 

  14. Wall, JJ. Compartment syndrome as a complication of the Hauser procedure. J Bone Joint Surg [Am] 1979; 61(2): 185–191.

    CAS  PubMed  Google Scholar 

  15. Barbari, S, TS Raugstad, N Lichtenberg et al. The Hauser operation for patellar dislocation: 3-32-year results in 63 knees. Acta Orthop Scand 1990; 61(1): 32–35.

    CAS  PubMed  Google Scholar 

  16. Juliusson, R, and G Markhede. A modified Hauser procedure for recurrent dislocation of the patella: A long-term follow-up study with special reference to osteoarthritis. Arch Orthop Trauma Surg 1984; 103(1): 42–46.

    Article  CAS  PubMed  Google Scholar 

  17. Hampson, WG, and P Hill. Late results of transfer of the tibial tubercle for recurrent dislocation of the patella. J Bone Joint Surg [Br] 1975; 57(2): 209–213.

    CAS  Google Scholar 

  18. Lanier, BE. Stuck medial patella: Unusual complication of a Hauser-Hughston patellar-shaving procedure. NY State J Med 1977; 77(12): 1955–1957.

    CAS  Google Scholar 

  19. DeCesare, WF. Late results of Hauser procedure for recurrent dislocation of the patella. Clin Orthop 1979(140): 137–144.

    PubMed  Google Scholar 

  20. Chrisman, OD, GA Snook, and TC Wilson. A longterm prospective study of the Hauser and Roux-Goldthwait procedures for recurrent patellar dislocation. Clin Orthop 1979(144): 27–30.

    PubMed  Google Scholar 

  21. Brown, DE, AH Alexander, and DM Lichtman. The Elmslie-Trillat procedure: Evaluation in patellar dislocation and subluxation. Am J Sports Med 1984; 12(2): 104–109.

    CAS  PubMed  Google Scholar 

  22. Cartier, P, C Cistac, and D Maulaz. Results of surgical treatment of patellar disequilibrium: Apropos of 311 cases. Acta Orthop Belg 1989; 55(3): 395–409.

    CAS  PubMed  Google Scholar 

  23. Cox, JS. Evaluation of the Roux-Elmslie-Trillat procedure for knee extensor realignment. Am J Sports Med 1982; 10(5): 303–310.

    CAS  PubMed  Google Scholar 

  24. Fielding, JW, WA Liebler, ND Krishne Urs et al. Tibial tubercle transfer: A long-range follow-up study. Clin Orthop 1979(144): p. 43–44.

    PubMed  Google Scholar 

  25. Larsen, E, and JE Varmarken. Recurrent dislocation of the patella: Two principles of treatment prospectively studied. Acta Orthop Belg 1988; 54(4): 434–438.

    CAS  PubMed  Google Scholar 

  26. Morshuis, WJ, PW Pavlov, and KP de Rooy. Anteromedialization of the tibial tuberosity in the treatment of patellofemoral pain and malalignment. Clin Orthop 1990(255): 242–250.

    PubMed  Google Scholar 

  27. Trillat, A, H DeJour, and A Couette. Diagnostic et traitement des subluxations recidivantes de la rotule. Rev Chir Orthop (Paris) 1964; 50: 813–824.

    CAS  PubMed  Google Scholar 

  28. Heegaard, J, PF Leyvraz, A Van Kampen et al. Influence of soft structures on patellar three-dimensional tracking. Clin Orthop 1994(299): 235–243.

    PubMed  Google Scholar 

  29. Ahmed, AM, and NA Duncan. Correlation of patellar tracking pattern with trochlear and retropatellar surface topographies. J Biomech Eng 2000; 122(6): 652–660.

    Article  CAS  PubMed  Google Scholar 

  30. Hautamaa, PV, DC Fithian, KR Kaufman et al. Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 1998(349): 174–182.

    PubMed  Google Scholar 

  31. Conlan, T, WP Garth, Jr., and JE Lemons. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 1993; 75(5): 682–693.

    CAS  PubMed  Google Scholar 

  32. Desio, SM, RT Burks, and KN Bachus. Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 1998; 26(1): 59–65.

    CAS  PubMed  Google Scholar 

  33. Burks, RT, SM Desio, KN Bachus et al. Biomechanical evaluation of lateral patellar dislocations. Am J Knee Surg 1998; 11(1): 24–31.

    CAS  PubMed  Google Scholar 

  34. Farahmand, F, MN Tahmasbi, and AA Amis. Lateral force-displacement behaviour of the human patella and its variation with knee flexion: A biomechanical study in vitro. J Biomech 1998; 31(12): 1147–1152.

    Article  CAS  PubMed  Google Scholar 

  35. Farahmand, F, W Senavongse, and AA Amis. Quantitative study of the quadriceps muscles and trochlear groove geometry related to instability of the patellofemoral joint. J Orthop Res 1998; 16(1): 136–143.

    Article  CAS  PubMed  Google Scholar 

  36. Sallay, PI, J Poggi, KP Speer et al. Acute dislocation of the patella: A correlative pathoanatomic study. Am J Sports Med 1996: 24(1): 52–60.

    CAS  PubMed  Google Scholar 

  37. Vainionpaa, S, E Laasonen, H Patiala et al. Acute dislocation of the patella: Clinical, radiographic and operative findings in 64 consecutive cases. Acta Orthop Scand 1986; 57(4): 331–333.

    CAS  PubMed  Google Scholar 

  38. Garth, WP Jr., DG DiChristina, and G Holt. Delayed proximal repair and distal realignment after patellar dislocation. Clin Orthop 2000(377): 132–144.

    PubMed  Google Scholar 

  39. Ahmad, CS, BE Stein, D Matuz et al. Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation: A review of eight cases. Am J Sports Med 2000; 28(6): 804–810.

    CAS  PubMed  Google Scholar 

  40. Avikainen, VJ, RK Nikku, and TK Seppanen-Lehmonen. Adductor magnus tenodesis for patellar dislocation: Technique and preliminary results. Clin Orthop 1993(297): 12–16.

    PubMed  Google Scholar 

  41. Nomura, E. Classification of lesions of the medial patellofemoral ligament in patellar dislocation. Int Orthop 1999; 23(5): 260–263.

    Article  CAS  PubMed  Google Scholar 

  42. Kirsch, MD, SW Fitzgerald, H Friedman et al. Transient lateral patellar dislocation: diagnosis with MR imaging. AJR Am J Roentgenol 1993; 161(1): 109–113.

    CAS  PubMed  Google Scholar 

  43. Spritzer, CE, DL Courneya, DL Burk Jr. et al. Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol 1997; 168(1): 117–122.

    CAS  PubMed  Google Scholar 

  44. Marangi, K, LM White, J Brossmann et al. Magnetic Resonance Imaging of the Knee Following Acute Lateral Patellar Dislocation, 63rd Annual Meeting of the American Academy of Orthopaedic Surgeons, Atlanta, GA, February 22–26, 1996.

    Google Scholar 

  45. Merchant, AC, RL Mercer, RH Jacobsen et al. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg [Am] 1974; 56(7): 1391–1396.

    CAS  PubMed  Google Scholar 

  46. Willems, S, R Litt, A Albassir et al. Comparative study of a series of normal knees and a series of knees with patellar instability. Acta Orthop Belg 1989; 55(3): 339–345.

    CAS  PubMed  Google Scholar 

  47. Warren, LF, and JL Marshall. The supporting structures and layers on the medial side of the knee: An anatomical analysis. J Bone Joint Surg [Am] 1979; 61(1): 56–62.

    CAS  PubMed  Google Scholar 

  48. Kaplan, EB. Factors responsible for the stability of the knee joint. Bull Hosp Joint Dis 1957; 18: 51–59.

    CAS  PubMed  Google Scholar 

  49. Reider, B, JL Marshall, B Koslin et al. The anterior aspect of the knee joint. J Bone Joint Surg [Am] 1981; 63(3): 351–356.

    CAS  PubMed  Google Scholar 

  50. Terry, GC. The anatomy of the extensor mechanism. Clin Sports Med 1989; 8(2): 163–177.

    CAS  PubMed  Google Scholar 

  51. Feller, JA, JA Feagin Jr., and WE Garrett Jr. The medial patellofemoral ligament revisited: An anatomical study. Knee Surg Sports Traumatol Arthrosc 1993; 1(3–4): 184–186.

    CAS  PubMed  Google Scholar 

  52. Nomura, E, Y Horiuchi, and M Kihara. Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 2000; 7(2): 121–127.

    Article  PubMed  Google Scholar 

  53. Nomura, E, T Fujikawa, T Takeda et al. Anatomical study of the medial patellofemoral ligament. Orthop Surg Suppl 1992; 22: 2–5.

    Google Scholar 

  54. Lieb, FJ, and J Perry. Quadriceps function: An anatomical and mechanical study using amputated limbs. J Bone Joint Surg Am 1968; 50(8): 1535–1548.

    CAS  PubMed  Google Scholar 

  55. Scharf, W, R Weinstrabl, and W Firbas. Anatomic studies of the extensor system of the knee joint and its clinical relevance. Unfallchirurg 1986; 89(10): 456–462.

    CAS  PubMed  Google Scholar 

  56. Powers, CM, JC Lilley, and TQ Lee. The effects of axial and multi-plane loading of the extensor mechanism on the patellofemoral joint. Clin Biomech (Bristol, Avon) 1998; 13: 616–624.

    Article  Google Scholar 

  57. Maldague, B, and J Malghem. Significance of the radiograph of the knee profile in the detection of patellar instability: Preliminary report. Rev Chir Orthop Reparatrice Appar Mot 1985; 71(Suppl 2): 5–13.

    PubMed  Google Scholar 

  58. Daniel, DM, J Lawler, LL Malcom et al. The quadriceps anterior cruciate interaction. J Bone Joint Surg 1982.

    Google Scholar 

  59. Bassett, FH. Acute dislocation of the patella, osteochondral fractures, and injuries to the extensor mechanism of the knee. In Amer Acad Orth Surg Instr Course Lect 1976; Amer Acad Orth Surg: Rosemont: 40–49.

    Google Scholar 

  60. Shoemaker, SC, and DM Daniel. The limits of knee motion: In vitro studies. In Daniel, DM, WH Akeson, and JJ O’Connor, eds., Knee Ligaments: Structure, Function, Injury, and Repair. New York: Raven Press, 1990, pp. 153–161.

    Google Scholar 

  61. Daniel, DM. Assessing the limits of knee motion. Am J Sports Med 1991; 19(2): 139–147.

    CAS  PubMed  Google Scholar 

  62. Daniel, DM. Diagnosis of a ligament injury. In Daniel, DM, WA Akeson, and JJ O’Connor, eds., Knee Ligaments: Structure, Function, Injury, and Repair. New York: Raven Press, 1990, pp. 3–10.

    Google Scholar 

  63. Teitge, RA, WW Faerber, P Des Madryl et al. Stress radiographs of the patellofemoral joint. J Bone Joint Surg Am 1996; 78(2): 193–203.

    CAS  PubMed  Google Scholar 

  64. Fithian, DC, DK Mishra, PF Balen et al. Instrumented measurement of patellar mobility. Am J Sports Med 1995; 23(5): 607–615.

    CAS  PubMed  Google Scholar 

  65. Noyes, FR, ES Grood, and PA Torzilli. Current concepts review: The definitions of terms for motion and position of the knee and injuries of the ligaments [see comments]. J Bone Joint Surg [Am] 1989; 71(3): 46–72.

    Google Scholar 

  66. Albee, RH. The bone graft wedge in the treatment of habitual dislocation of the patella. Med Record 1915; 88: 257–259.

    Google Scholar 

  67. Brattstrom, H. Shape of the intercondylar groove normally and in recurrent dislocation of patella: A clinical and x-ray anatomical investigation. Acta Orth Scand Suppl 1964; 68: 134–148.

    Google Scholar 

  68. Wiberg, G. Roentgenographic and anatomic studies on the patellofemoral joint: With special reference to chondromalacia patella. Acta Orthop Scand 1941; 12: 319–410.

    Google Scholar 

  69. Heywood, AWB. Recurrent dislocation of the patella: a study of its pathology and treatment in 106 knees. J Bone Joint Surg Br 1961; 43: 508–517.

    Google Scholar 

  70. Cash, JD, and JC Hughston. Treatment of acute patellar dislocation. Am J Sports Med 1988; 16(3): 244–249.

    CAS  PubMed  Google Scholar 

  71. Maenpaa, H, and MU Lehto. Patellar dislocation has predisposing factors: A roentgenographic study on lateral and tangential views in patients and healthy controls. Knee Surg Sports Traumatol Arthrosc 1996; 4(4): 212–216.

    CAS  PubMed  Google Scholar 

  72. Larsen, E, and F Lauridsen, Conservative treatment of patellar dislocations: Influence of evident factors on the tendency to redislocation and the therapeutic result. Clin Orthop 1982(171): 131–136.

    PubMed  Google Scholar 

  73. Lerat, JL. Morphotypes of patellar instability. Rev Chir Orthop Reparatrice Appar Mot 1982; 68(1): 50–52.

    CAS  PubMed  Google Scholar 

  74. Floyd, A, P Phillips, MR Khan et al. Recurrent dislocation of the patella: Histochemical and electromyographic evidence of primary muscle pathology. J Bone Joint Surg [Br] 1987; 69(5): 790–793.

    CAS  Google Scholar 

  75. MacNab, I. Recurrent dislocation of the patella. J Bone Joint Surg Br 1952; 34: 957–967.

    Google Scholar 

  76. Runow, A. The dislocating patella: Etiology and prognosis in relation to generalized joint laxity and anatomy of the patellar articulation. Acta Orthop Scand Suppl 1983; 201: 1–53.

    CAS  PubMed  Google Scholar 

  77. Dejour, H, G Walch, P Neyret et al. Dysplasia of the femoral trochlea. Rev Chir Orthop Reparatrice Appar Mot 1990; 76(1): 45–54.

    CAS  PubMed  Google Scholar 

  78. Murray, TF, JY Dupont, and JP Fulkerson. Axial and lateral radiographs in evaluating patellofemoral malalignment. Am J Sports Med 1999; 27(5): 580–584.

    CAS  PubMed  Google Scholar 

  79. Insall, J, PG Bullough, and AH Burstein. Proximal “tube” realignment of the patella for chondromalacia patellae. Clin Orthop 1979(144): 63–69.

    PubMed  Google Scholar 

  80. Nietosvaara, Y, and K Aalto. The cartilaginous femoral sulcus in children with patellar dislocation: An ultrasonographic study. J Pediatr Orthop 1997; 17(1): 50–53.

    Article  CAS  PubMed  Google Scholar 

  81. Jacobsen, K, and P Metz. Occult traumatic dislocation of the patella. J Trauma 1976; 16(10): 829–835.

    CAS  PubMed  Google Scholar 

  82. Kujala, UM, K Osterman, M Kormano et al. Patellofemoral relationships in recurrent patellar dislocation. J Bone Joint Surg [Br] 1989; 71(5): 788–792.

    CAS  Google Scholar 

  83. Schutzer, SF, GR Ramsby, and JP Fulkerson. Computed tomographic classification of patellofemoral pain patients. Orthop Clin North Am 1986; 17(2): 235–248.

    CAS  PubMed  Google Scholar 

  84. Buard, J, J Benoit, A Lortat-Jacob et al. The depth of the patellar groove of the femur (author’s trans.). Rev Chir Orthop Reparatrice Appar Mot 1981; 67(8): 721–729.

    CAS  PubMed  Google Scholar 

  85. Simmons, E Jr., and JC Cameron. Patella alta and recurrent dislocation of the patella. Clin Orthop 1992(274): 265–269.

    PubMed  Google Scholar 

  86. Leung, YF, YL Wai, and YC Leung. Patella alta in southern China: A new method of measurement. Int Orthop 1996; 20(5): 305–310.

    Article  CAS  PubMed  Google Scholar 

  87. Lancourt, JE, and JA Cristini. Patella alta and patella infera: Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle. J Bone Joint Surg [Am] 1975; 57(8): 1112–1115.

    CAS  PubMed  Google Scholar 

  88. Caton, J, A Mironneau, G Walch et al. Idiopathic high patella in adolescents. Apropos of 61 surgical cases. Rev Chir Orthop Reparatrice Appar Mot 1990; 76(4): 253–260.

    CAS  PubMed  Google Scholar 

  89. Glimet, T. Course of recurrent dislocation of the patella, patellar syndrome without dislocation and femoropatellar osteoarthritis. Ann Radiol (Paris) 1993; 36(3): 215–219.

    CAS  PubMed  Google Scholar 

  90. Insall, J, V Goldberg, and E Salvati. Recurrent dislocation and the high-riding patella. Clin Orthop 1972; 88: 67–69.

    CAS  PubMed  Google Scholar 

  91. Blackburne, JS, and TE Peel. A new method of measuring patellar height. J Bone Joint Surg Br 1977; 59(2): 241–242.

    CAS  PubMed  Google Scholar 

  92. Bernageau, J, D Goutallier, J Debeyre et al. New exploration technic of the patellofemoral joint: Relaxed axial quadriceps and contracted quadriceps. Rev Chir Orthop Reparatrice Appar Mot 1975; 61(Suppl 2): 286–290.

    PubMed  Google Scholar 

  93. Kimberlin, GE. Radiological assessment of the patellofemoral articulation and subluxation of the patella. Radiol Technol 1973; 45(3): 129–137.

    CAS  PubMed  Google Scholar 

  94. Norman, O, N Egund, L Ekelund et al. The vertical position of the patella. Acta Orthop Scand 1983; 54(6): 908–913.

    CAS  PubMed  Google Scholar 

  95. Aparicio, G, JC Abril, J Albinana et al. Patellar height ratios in children: An interobserver study of three methods. J Pediatr Orthop B 1999; 8(1): 29–32.

    CAS  PubMed  Google Scholar 

  96. Geenen, E, G Molenaers, and M Martens. Patella alta in patellofemoral instability. Acta Orthop Belg 1989; 55(3): 387–393.

    CAS  PubMed  Google Scholar 

  97. Hvid, I, LI Andersen, and H Schmidt. Patellar height and femoral trochlear development. Acta Orthop Scand 1983; 54(1): 91–93.

    CAS  PubMed  Google Scholar 

  98. Dejour, H, G Walch, L Nove-Josserand et al. Factors of patellar instability: An anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2(1): 19–26.

    Article  CAS  PubMed  Google Scholar 

  99. Guzzanti, V, A Gigante, A Di Lazzaro et al. Patellofemoral malalignment in adolescents: Computerized tomographic assessment with or without quadriceps contraction. Am J Sports Med 1994; 22(1): 55–60.

    CAS  PubMed  Google Scholar 

  100. Shelbourne, KD, DA Porter, and W Rozzi. Use of a modified Elmslie-Trillat procedure to improve abnormal patellar congruence angle. Am J Sports Med 1994; 22(3): 318–323.

    CAS  PubMed  Google Scholar 

  101. Malghem, J, and B Maldague. Patellofemoral joint: 30 degrees axial radiograph with lateral rotation of the leg. Radiology 1989; 170(2): 566–567.

    CAS  PubMed  Google Scholar 

  102. Dixon, AM. Demonstration of lateral patellar subluxation: The 30 degrees LR projection lateral rotation. Radiogr Today 1991; 57(647): 20–21.

    CAS  PubMed  Google Scholar 

  103. Morscher, E. Indications and possibilities of patella wedge osteotomy. Orthopade 1985; 14(4): 261–265.

    CAS  PubMed  Google Scholar 

  104. Schutzer, SF, GR Ramsby, and JP Fulkerson. The evaluation of patellofemoral pain using computerized tomography: A preliminary study. Clin Orthop 1986(204): 286–293.

    PubMed  Google Scholar 

  105. Somer, T, and B Bokorov. The axial image of the femoropatellar joint. Med Pregl 1985; 38(5–6): 283–287.

    Google Scholar 

  106. Moller, BN, B Krebs, and AG Jurik. Patellofemoral incongruence in chondromalacia and instability of the patella. Acta Orthop Scand 1986; 57(3): 232–234.

    CAS  PubMed  Google Scholar 

  107. Nove-Josserand, L, and D Dejour. Quadriceps dysplasia and patellar tilt in objective patellar instability. Rev Chir Orthop Reparatrice Appar Mot 1995; 81(6): 497–504.

    CAS  PubMed  Google Scholar 

  108. Staubli, HU, U Durrenmatt, B Porcellini et al. Anatomy and surface geometry of the patellofemoral joint in the axial plane. J Bone Joint Surg Br 1999; 81(3): 452–458.

    CAS  PubMed  Google Scholar 

  109. Nietosvaara, Y. The femoral sulcus in children: An ultrasonographic study. J Bone Joint Surg Br 1994; 76(5): 807–809.

    CAS  PubMed  Google Scholar 

  110. Delgado-Martinez, AD, C Estrada, EC Rodriguez-Merchan et al. CT scanning of the patellofemoral joint: The quadriceps relaxed or contracted? Int Orthop 1996; 20(3): 159–162.

    CAS  PubMed  Google Scholar 

  111. Arendt, E, Personal Communication 1996.

    Google Scholar 

  112. Ficat, RP, J Philippe, and DS Hungerford. Chondromalacia patellae: A system of classification. Clin Orthop 1979(144): 55–62.

    PubMed  Google Scholar 

  113. Stanitski, CL. Articular hypermobility and chondral injury in patients with acute patellar dislocation. Am J Sports Med 1995; 23(2): 146–150.

    CAS  PubMed  Google Scholar 

  114. Gunn, DR. Contracture of the quadriceps muscle: A discussion on the etiology and relationship to recurrent dislocation of the patella. J Bone Joint Surg Br 1964; 46: 492–497.

    CAS  PubMed  Google Scholar 

  115. Jeffreys, TE. Recurrent dislocation of the patella due to abnormal attachment of the ilio-tibial tract. J Bone Joint Surg Br 1963; 45: 740–743.

    CAS  PubMed  Google Scholar 

  116. Beighton, PH, and FT Horan. Dominant inheritance in familial generalised articular hypermobility. J Bone Joint Surg Br 1970; 52(1): 145–147.

    CAS  PubMed  Google Scholar 

  117. Carter, C, and R Sweetnam. Familial joint laxity and recurrent dislocation of the patella. J Bone Joint Surg Br 1958; 40: 664–667.

    PubMed  Google Scholar 

  118. Ahstrom, JP Jr. Osteochondral fracture in the knee joint associated with hypermobility and dislocation of the patella: Report of eighteen cases. J Bone Joint Surg [Am] 1965; 47(8): 1491–1502.

    PubMed  Google Scholar 

  119. Mariani, PP, and I Caruso. An electromyographic investigation of subluxation of the patella. J Bone Joint Surg Br 1979; 61-B(2): 169–171.

    CAS  PubMed  Google Scholar 

  120. Fox, TA. Dysplasia of the quadriceps mechanism: Hypoplasia of the vastus medialis muscle as related to the hypermobile patella syndrome. Surg Clin North Am 1975; 55: 199–226.

    CAS  PubMed  Google Scholar 

  121. Miller, GF. Familial recurrent dislocation of the patella. J Bone Joint Surg [Br] 1978; 60-B(2): 203–204.

    CAS  Google Scholar 

  122. Rouvillain, JL, N Piquion, A Lepage-Lezin et al. A familial form of bilateral recurrent dislocation of the patella with major trochlea dysplasia. Rev Chir Orthop Reparatrice Appar Mot 1998; 84(3): 285–291.

    CAS  PubMed  Google Scholar 

  123. Boden, BP, AW Pearsall, WE Garrett Jr. et al. Patellofemoral instability: Evaluation and management. J Am Acad Orthop Surg 1997; 5(1): 47–57.

    PubMed  Google Scholar 

  124. Maenpaa, H, and MU Lehto. Patellar dislocation: The long-term results of nonoperative management in 100 patients. Am J Sports Med 1997; 25(2): 213–217.

    CAS  PubMed  Google Scholar 

  125. O’Donoghue, DH. Treatment of Injuries to Athletes, 3rd ed. Philadelphia: Saunders, 1976, pp. 600–617.

    Google Scholar 

  126. Sargent, JR, and WA Teipner. Medial patellar retinacular repair for acute and recurrent dislocation of the patella-a preliminary report. J Bone Joint Surg [Am] 1971; 53: 386.

    Google Scholar 

  127. Murphy, PG, CB Frank, and DA Hart. The cell biology of ligaments and ligament healing. In Jackson, DW, ed., The Anterior Cruciate Ligament: Current and Future Concepts. New York: Raven Press, 1993, pp. 165–177.

    Google Scholar 

  128. Vainionpaa, S, E Laasonen, T Silvennoinen et al. Acute dislocation of the patella: A prospective review of operative treatment. J Bone Joint Surg [Br] 1990; 72(3): 366–369.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Kaiser Permanente Medical Group, El Cajon, California, USA

    Donald C. Fithian MD (Member of the “International Patellofemoral Study Group”)

  2. Orthopaedic Surgery, Kawasaki Municipal Hospital, Kawasaki, Japan

    Eiki Nomura MD (Department Director)

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  1. Donald C. Fithian MD
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  2. Eiki Nomura MD
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  1. Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain

    Vicente Sanchis-Alfonso MD, PhD (Member of the International Patellofemoral Study Group/Member of the ACL Study Group) (Member of the International Patellofemoral Study Group/Member of the ACL Study Group)

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© 2006 Springer-Verlag London Limited

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Fithian, D.C., Nomura, E. (2006). Anatomy of Patellar Dislocation. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, London. https://doi.org/10.1007/1-84628-143-1_5

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  • DOI: https://doi.org/10.1007/1-84628-143-1_5

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-003-0

  • Online ISBN: 978-1-84628-143-3

  • eBook Packages: MedicineMedicine (R0)

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