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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 February;50(1):7-14
Combined open and arthroscopic treatment for patellar instability
Forti M., Atzori F., Pesce C., Seccia A., Pipino R.
Background. Surgery can be considered in the treatment of patellar instability with associated hypermobility, only after the failure of a conservative therapy for a period of six months.
Methods. From January 1994 to September 1998, twenty-one patients have been surgically treated for a total of twenty-three knees (bilateral in two cases). All of them had followed a prolonged physiotherapeutic protocol before being operated. The surgical technique used is the one proposed by Brief in 1993 and consists of a combined open and arthroscopic approach. Eighteen patients have been reevaluated after surgery for a total of twenty knees. An axial X-ray of the patellae and a clinical examination were made for each subject.
Results. The data concerning symptoms have deserved an excellent or good improvement in 80%, a moderate improvement in 15% and a bad evaluation in 5% of the cases (one patient). Objectively, a good function and stability of the knee was present in almost all the patients. The worse results were found in those knees which suffered for a more complex pathology and not only for isolated instability with associated hypermobility.
Conclusions. The results obtained from this study are similar to those found in the original work by Brief and confirm the qualities of his rapid and easy surgical procedure. Anyway, a great importance must be given to the diagnostic phases and to the first therapeutic attempt which is always conservative.