What is it about?
Patellar dislocations are common, particularly in adolescent females and athletes. Normally, the patella is dislocated extra-articularly and almost always laterally. Patients usually present to the emergency clinic with an inability to extend an obviously deformed knee. In this article, we reported the case with the knee locked in extension, with a “dorsal fin” appearance of the soft tissues tented over the patella which was rotated 90 degrees about the vertical axis. This is very rare condition and only a few cases have been reported until now.
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Why is it important?
This is the first case in the literature to provide post reduction arthroscopic imaging showing that successful reduction can be achieved without any damage to the joint. In this case, although closed reduction in the emergency room was unsuccessful, under a general anaesthetic with muscle relaxant the patella was successfully relocated using a closed technique in the operation theatre. Attempting to reduce the patella repeatedly could result in unnecessary damage to the patellofemoral joint and lead to early arthritis.
Perspectives
In any patellar dislocation cases, attempting to reduce the patella with excessive force or repeatedly without success should be avoided. I suggest a reduction under general anaesthetic with muscle relaxant followed by immediate arthroscopic examination of the knee joint, as assessing for osteochondral damage is important especially in difficult cases.
Mr Vikas Khanduja
University of Cambridge
Read the Original
This page is a summary of: Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella, Case Reports in Orthopedics, January 2015, Hindawi Publishing Corporation,
DOI: 10.1155/2015/328386.
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