Patellar instability: combined treatment with Goldthwait technique and arthroscopic lateral release

Patellar instability is a frequent cause of knee pain in childhood and adolescence. Treatment is usually conservative especially after a single episode of dislocation, although in cases of recurrence the surgical option needs to be evaluated. The techniques proposed involve only soft tissues in order to preserve the skeletal maturation. This study evaluates the long-term results on 20 knees in 19 adolescents affected by patellar instability treated with the distal realignment procedure involving medial transfer of the lateral hemi-patellar tendon according to Goldthwait technique, preceded by arthroscopy to perform lateral release. The results were analysed with the Cox grading system and showed 11 excellent cases, 6 good cases, 2 fair cases and 1 poor case. Similar findings were obtained with the Bray score.