Management of valgus knee with irreducible patellar dislocation and MCL rupture: A case series

INTRODUCTION: The high rate of recurrence in patellar dislocation treatment, requires a more comprehensive action, this is due to causes not only single but often multifactorial, including problems with static stability, dynamic stability or both.

PRESENTATION OF CASE: 1st case: A-39-years-old male, complain of irreducible right patella dislocation with valgus knee and already done soft tissue procedure for patella dislocation. Long-leg radiographs of the right leg showed 18° valgus mechanical angle. 2nd case: A-26-years-old obese female, complain of dislocation of left patella and history of surgery for dislocation at 5 years old. Long-leg radiographs of the right leg showed 11° valgus mechanical angle.

DISCUSSION: After knowing the cause of the patellar dislocation from history taking, physical and supporting examination, we performed lateral open wedge distal femoral osteotomy also MPFL and MCL reconstruction, and tibial tuberosity medialization osteotomy. There is improvement mean score in Tegner Lysholm Knee Scoring system and IKDC Scoring at 6 months after surgery.

CONCLUSION: Lateral open wedge distal femur osteotomy combine with MPFL and MCL reconstruction and tibial tuberosity medialization realignment procedure can be successfully done for improve irreducible patellar dislocation in valgus knee, from clinical and radiological evaluation have good outcome after surgery.