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2015 ; 35
(ä): 26-33
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Medial Patella Subluxation: Diagnosis and Treatment
#MMPMID26361441
McCarthy MA
; Bollier MJ
Iowa Orthop J
2015[]; 35
(ä): 26-33
PMID26361441
show ga
Medial patella subluxation is a disabling condition typically associated with
previous patellofemoral instability surgery. Patients often describe achy pain
with painful popping episodes. They often report that the patella shifts
laterally, which occurs as the medial subluxed patella dramatically shifts into
the trochlear groove during early knee flexion. Physical examination is
diagnostic with a positive medial subluxation test. Nonoperative treatment, such
as focused physical therapy and patellofemoral stabilizing brace, is often
unsuccessful. Primary surgical options include lateral retinacular
repair/imbrication or lateral reconstruction. Prevention is key to avoid medial
patella subluxation. When considering patellofemoral surgery, important factors
include appropriate lateral release indications, consideration of lateral
retinacular lengthening vs release, correct MPFL graft placement and tension, and
avoiding excessive medialization during tubercle transfer. This review article
will analyze patient symptoms, diagnostic exam findings and appropriate treatment
options, as well as pearls to avoid this painful clinical entity.
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