Y. Nishanth Shetty
Yenepoya University, IndiaTitle: Management of multifactorial causes of Patellofemoral Instability in a 19 year old girl
Abstract
Patellofemoral instability is a common cause of recurrent patellar dislocation in adolescent females and athletes. The various risk factors for this condition include generalised ligamentous laxity, abnormal lower limb alignment. abnormal patella and trochlear morphology. We report a case where we encountered multiple factors causing recurrent patellar instability and addressed each problem in a step by step surgical approach.
Case Report: A 19 year old female presented with 5 episodes of recurrent patella dislocation a year. On examination, she had a beighton score of 8/11,a positive J sign and apprehension test. Radiographic evaluation showed a laterally subluxed patella with trochlear dysplasia and patella alta. CT scan and MRI confirmed a dejour type 2 trochlear dysplasia with increased tibial tuberosity –trochlear Groove distance and a deficient medial patellofemoral ligament(MPFL). She underwent an MPFL reconstruction with deepening trochleoplasty and medialization of the tibial tubercle.
Conclusion: This case highlights the complex presentation of patellar instability and the need for careful clinical and radiographic evaluation, along with a step by step surgical correction f each problem. This is to prevent overdoing any one procedure while addressing a multi factorial pathology by a surgeon resulting in increased patellofemoral pressures but instead use multiple procedures to ensure efficient correction and good clinicalresult.
Biography
Nishanth Shetty has completed his Master of Surgery in Orthopedics at the age of 32 from K.S.Hegde Medical Academy and then pursued his fellowship in Arthroplasty and Arthroscopic Surgery in Lakeshore Hospital ,Kochi after which he did another fellowship in Bumin Hospital,Busan, South Korea where he was trained in complex and revision Hip and Knee Arthroplasty. He is currently an Assistant Professor in Yenepoya Medical College Hospital,Mangalore
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