Surgery for patellar dislocation has evolved towards anatomical reconstructions with assessment and treatment of anatomi
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Surgery for patellar dislocation has evolved towards anatomical reconstructions with assessment and treatment of anatomical risk factors Mikko M. Uimonen1 · Jussi P. Repo1 · Tuomas T. Huttunen2,3,4 · Heikki Nurmi1 · Ville M. Mattila3,4,5 · Juha Paloneva1,6 Received: 30 April 2020 / Accepted: 10 September 2020 © The Author(s) 2020
Abstract Purpose Increasing knowledge on the treatment of patellar dislocation has resulted in the development of new surgical techniques for patella stabilisation. National incidence and trends in surgery for patellar dislocation were examined using data from the Finnish National Hospital Discharge Register (NHDR). The hypothesis was that an increased understanding of the pathophysiology of patellar instability has increased the popularity of reconstructing damaged structures and modification of anatomical risk factors. Methods Data from the years 1997–2016 were collected from the NHDR database using ICD-10 diagnostic codes and the Nomesco Classification of Surgical Procedures (NCSP) codes. Surgical procedures were categorised into subgroups representing the main surgical approaches of patellar dislocation. Total incidence of surgery for patellar dislocation and change in incidence during the study period were calculated. Results A total of 9702 operations for patellar dislocation were performed during the study period. Median (IQR) patient age at time of primary surgery was 23 (18–34) years. The total incidence of surgeries remained stable across the study period at of 8.9 per 100,000 person-years. Incidences of ligament reconstruction, femoral osteotomies and osteochondral fragment reimplantation operations multiplied during the study period. Ligament reconstruction procedures were the most performed operations at the end of the study period. Conclusion The incidence of surgical procedures for patellar dislocation remained unchanged during the years 1997–2016. Ligament reconstruction procedures increased in popularity. Surgical techniques have shifted towards the reconstruction of damaged structures and the modification of congenital anatomical risk factors for patellar dislocation. Diversified surgical techniques have enabled the tailoring and combining of stabilizing procedures according to the patient’s individual anatomy. Keywords Patellar dislocation · Patellar dislocation surgery · Incidence · Knee injury
Introduction * Mikko M. Uimonen [email protected] 1
Department of Surgery, Central Finland Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland
2
Department of Emergency, Anaesthesia and Pain Medicine, Tampere University Hospital, Tampere, Finland
3
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
4
Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
5
COXA Hospital for Joint Replacement, Tampere, Finland
6
University of Eastern Finland, Kuopio, Finland
Lateral patellar dislocation is a common knee injury in the young, active population [3, 17, 35]. Indeed, previous
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