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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2009

01-04-2009 | Knee

Surgical treatment of patellar dislocation in children with Down syndrome: a 3- to 11-year follow-up study

Authors: Camilla Bettuzzi, Manuele Lampasi, Marina Magnani, Onofrio Donzelli

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2009

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Abstract

We report results of surgical treatment of ten knees affected by patellar dislocation in six children with Down syndrome. Four knees showed a dislocatable patella (grade III according to Dugdale), two a dislocated reducible patella (grade IV) and four a dislocated irreducible patella (grade V). Symptoms included frequent falls, limping and pain. In all the cases a Roux–Goldthwait–Campbell procedure was performed. Mean age at surgery was 10 years (range 6 years and 6 months to 13 years and 4 months). Patients were reviewed at an average follow-up of 8 years and 8 months (range 3 years and 6 months to 11 years and 5 months). None showed signs of recurrence of the dislocation. The median Lysholm score improved from 57.5 to 91/100. Statistical analysis showed a significant effectiveness of the procedure in improving function, and that surgery was significantly more effective in patients with more severe disability.
Literature
1.
go back to reference Andrish J (2007) Surgical options for patellar stabilization in the skeletally immature patient. Sports Med Arthrosc 15:82–88PubMedCrossRef Andrish J (2007) Surgical options for patellar stabilization in the skeletally immature patient. Sports Med Arthrosc 15:82–88PubMedCrossRef
2.
go back to reference Beals RK, Buehler K (1997) Treatment of patellofemoral instability in childhood with creation of a femoral sulcus. J Pediatr Orthop 17:516–519PubMedCrossRef Beals RK, Buehler K (1997) Treatment of patellofemoral instability in childhood with creation of a femoral sulcus. J Pediatr Orthop 17:516–519PubMedCrossRef
3.
go back to reference Caird MS, Wills BPD, Dormans JP (2006) Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg 14:610–619PubMed Caird MS, Wills BPD, Dormans JP (2006) Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg 14:610–619PubMed
4.
go back to reference Carpintero P, Mesa M, Carpintero A (1996) Bilateral congenital dislocation of the patella. Acta Orthop Belg 62:113–115PubMed Carpintero P, Mesa M, Carpintero A (1996) Bilateral congenital dislocation of the patella. Acta Orthop Belg 62:113–115PubMed
5.
go back to reference Crenshaw AH (1963) Campbell’s operative orthopaedics, 4th edn. The C·V. Mosby Company, Saint Louis, pp 352–356 Crenshaw AH (1963) Campbell’s operative orthopaedics, 4th edn. The C·V. Mosby Company, Saint Louis, pp 352–356
6.
go back to reference Dandy DJ, Griffiths D (1989) Lateral release for recurrent dislocation of the patella. J Bone Joint Surg Br 71:121–125PubMed Dandy DJ, Griffiths D (1989) Lateral release for recurrent dislocation of the patella. J Bone Joint Surg Br 71:121–125PubMed
7.
go back to reference Diamond LS, Lynne D, Sigman B (1981) Orthopedic disorders in patiens with Down’s syndrome. Orthop Clin North Am 12:57–71PubMed Diamond LS, Lynne D, Sigman B (1981) Orthopedic disorders in patiens with Down’s syndrome. Orthop Clin North Am 12:57–71PubMed
8.
go back to reference Dugdale T, Renshaw T (1986) Instability of the patellofemoral joint in Down syndrome. J Bone Joint Surg Am 68-A:405–413 Dugdale T, Renshaw T (1986) Instability of the patellofemoral joint in Down syndrome. J Bone Joint Surg Am 68-A:405–413
10.
go back to reference Gao GX, Lee EH, Bose K (1990) Surgical management of congenital and habitual dislocation of the patella. J Pediatr Orthop 10:255–260PubMed Gao GX, Lee EH, Bose K (1990) Surgical management of congenital and habitual dislocation of the patella. J Pediatr Orthop 10:255–260PubMed
11.
go back to reference Ghanem I, Wattincourt L, Seringe R (2000) Congenital dislocation of the patella. Part I. Pathologic anatomy. J Pediatr Orthop 20:812–816PubMed Ghanem I, Wattincourt L, Seringe R (2000) Congenital dislocation of the patella. Part I. Pathologic anatomy. J Pediatr Orthop 20:812–816PubMed
12.
go back to reference Gordon JE, Schoenecker PL (1999) Surgical treatment of congenital dislocation of the patella. J Pediatr Orthop 19:260–264PubMedCrossRef Gordon JE, Schoenecker PL (1999) Surgical treatment of congenital dislocation of the patella. J Pediatr Orthop 19:260–264PubMedCrossRef
13.
go back to reference Hennequin M, Morin C, Feine JS (2000) Pain expression and stimulus localisation in individuals with Down’s syndrome. Lancet 2 356:1882–1887CrossRef Hennequin M, Morin C, Feine JS (2000) Pain expression and stimulus localisation in individuals with Down’s syndrome. Lancet 2 356:1882–1887CrossRef
14.
go back to reference Joo SY, Park KB, Kim BR, Park HW, Kim HW (2007) The ‘four-in-one’ procedure for habitual dislocation of the patella in children: early results in patients with severe generalised ligamentous laxity and aplasis of the trochlear groove. J Bone Joint Surg Br 89:1645–1649PubMedCrossRef Joo SY, Park KB, Kim BR, Park HW, Kim HW (2007) The ‘four-in-one’ procedure for habitual dislocation of the patella in children: early results in patients with severe generalised ligamentous laxity and aplasis of the trochlear groove. J Bone Joint Surg Br 89:1645–1649PubMedCrossRef
15.
go back to reference Koplewitz BZ, Babyn PS, Cole WG (2005) Congenital dislocation of the patella. AJR Am J Roentgenol 184:1640–1646PubMed Koplewitz BZ, Babyn PS, Cole WG (2005) Congenital dislocation of the patella. AJR Am J Roentgenol 184:1640–1646PubMed
16.
go back to reference Langenskiöld A, Ritsilä V (1992) Congenital dislocation of the patella and its operative treatment. J Pediatr Orthop 12:315–323PubMed Langenskiöld A, Ritsilä V (1992) Congenital dislocation of the patella and its operative treatment. J Pediatr Orthop 12:315–323PubMed
17.
go back to reference Livingstone B, Hirst P (1986) Orthopedic disorders in school children with Down’s syndrome with special reference to the incident of joint laxity. Clin Orthop Relat Res 207:74–76PubMed Livingstone B, Hirst P (1986) Orthopedic disorders in school children with Down’s syndrome with special reference to the incident of joint laxity. Clin Orthop Relat Res 207:74–76PubMed
18.
go back to reference McCall RE, Lessenberry HB (1987) Bilateral congenital dislocation of the patella. J Pediatr Orthop 7:100–102PubMed McCall RE, Lessenberry HB (1987) Bilateral congenital dislocation of the patella. J Pediatr Orthop 7:100–102PubMed
19.
go back to reference Mendez A, Keret D, MacEwen GD (1988) Treatment of patellofemoral instability in Down’s syndrome. Clin Orthop Relat Res 234:148–158PubMed Mendez A, Keret D, MacEwen GD (1988) Treatment of patellofemoral instability in Down’s syndrome. Clin Orthop Relat Res 234:148–158PubMed
20.
go back to reference Merrick J, Ezra E, Josef B, Hendel D, Steinberg DM, Wientroub S (2000) Musculoskeletal problems in Down syndrome European paediatric orthopaedic society survey: the Israeli sample. J Pediatr Orthop B 9:185–192PubMed Merrick J, Ezra E, Josef B, Hendel D, Steinberg DM, Wientroub S (2000) Musculoskeletal problems in Down syndrome European paediatric orthopaedic society survey: the Israeli sample. J Pediatr Orthop B 9:185–192PubMed
21.
go back to reference Mizobuchi RR, Galbiatti JA, Quirici Neto F, Milani C, Fujiki EN, de Oliveira HC, Navarro RD, Bensahel H (2007) Ultrasonographic study of the femoro-patellar joint and its attachments in infant from birth to 24 months of age. Part II. Children with Down syndrome. J Pediatr Orthop B 16:266–268PubMed Mizobuchi RR, Galbiatti JA, Quirici Neto F, Milani C, Fujiki EN, de Oliveira HC, Navarro RD, Bensahel H (2007) Ultrasonographic study of the femoro-patellar joint and its attachments in infant from birth to 24 months of age. Part II. Children with Down syndrome. J Pediatr Orthop B 16:266–268PubMed
22.
go back to reference Nomura E, Inoue M, Kobayashi S (2006) Generalized joint laxity and contralateral patellar hypermobility in unilateral recurrent patellar dislocators. Arthroscopy 22:861–865PubMed Nomura E, Inoue M, Kobayashi S (2006) Generalized joint laxity and contralateral patellar hypermobility in unilateral recurrent patellar dislocators. Arthroscopy 22:861–865PubMed
23.
go back to reference Panni AS, Tartarone M, Patricola A, Paxton EW, Fithian DC (2005) Long-term results of lateral retinacular release. Arthroscopy 21:526–531PubMedCrossRef Panni AS, Tartarone M, Patricola A, Paxton EW, Fithian DC (2005) Long-term results of lateral retinacular release. Arthroscopy 21:526–531PubMedCrossRef
24.
go back to reference Ricchetti ET, Mehta S, Sennett BJ, Huffman GR (2007) Comparison of lateral release versus lateral release with medial soft-tissue realignment for the treatment of recurrent patellar instability: a systematic review. Arthroscopy 23:463–468PubMed Ricchetti ET, Mehta S, Sennett BJ, Huffman GR (2007) Comparison of lateral release versus lateral release with medial soft-tissue realignment for the treatment of recurrent patellar instability: a systematic review. Arthroscopy 23:463–468PubMed
26.
go back to reference Stanisavljevic S, Zemenick G, Miller D (1976) Congenital, irreducible, permanent lateral dislocation of the patella. Clin Orthop Relat Res 116:190–199PubMed Stanisavljevic S, Zemenick G, Miller D (1976) Congenital, irreducible, permanent lateral dislocation of the patella. Clin Orthop Relat Res 116:190–199PubMed
27.
go back to reference Tegner Y, Lysholm MD (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed Tegner Y, Lysholm MD (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed
28.
go back to reference von Knoch F, Böhm T, Bürgi ML, von Knoch M, Bereiter H (2006) Trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia: a 4- to 14-year follow-up study. J Bone Joint Surg Br 88:1331–1335 von Knoch F, Böhm T, Bürgi ML, von Knoch M, Bereiter H (2006) Trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia: a 4- to 14-year follow-up study. J Bone Joint Surg Br 88:1331–1335
29.
go back to reference Winell J, Burke SW (2003) Sport participation of children with Down syndrome. Orthop Clin North Am 34:439–443PubMedCrossRef Winell J, Burke SW (2003) Sport participation of children with Down syndrome. Orthop Clin North Am 34:439–443PubMedCrossRef
Metadata
Title
Surgical treatment of patellar dislocation in children with Down syndrome: a 3- to 11-year follow-up study
Authors
Camilla Bettuzzi
Manuele Lampasi
Marina Magnani
Onofrio Donzelli
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2009
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-008-0652-5

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