Recurrent XXXX treated by the modified Roux-Goldthwait procedure. A prospective study of forty-seven knees.

@entity1 @entity1844 @entity12351 @entity625 @entity4040 @entity39 @entity1410 @entity158 @entity8018
We studied the results in forty-seven knees in thirty-seven @entity1 - ten male and twenty-seven female - who had recurrent @entity12351 and were treated by a modified Roux-Goldthwait procedure (lateral retinacular release, medial transfer of the lateral patellar tendon without advancement, plication of the medial retinaculum, and advancement of the vastus medialis). Ten of the female @entity1 had bilateral dislocation. The results were analyzed after follow-ups ranging from 3.0 to 16.3 years (average, 5.8 years). The study confirmed that a tangential radiograph of the patellofemoral joint, made with the knee in 20 degrees of flexion, is reliable in determining patellar displacement. The results were excellent in twelve knees, good in thirty-one, fair in one, and poor in three. The fair and poor ratings were due to @entity158 caused by severe @entity1844 patellae. The @entity1 with a fair result had had recurrent dislocations after the Roux-Goldthwait procedure due to a very lax synovial and capsular sac. Reoperation with tightening of the sac medially and laterally eliminated @entity8018 in this @entity1 and established straight patellar tracking. There was one serious complication, a large subcutaneous @entity1410 with @entity39 of a skin flap. The @entity1 with mild @entity1844 improved and showed no progressive @entity625 after simple realignment, while those with severe @entity1844 were not improved by shaving, drilling, and realignment. Preliminary results indicated that a modified Maquet procedure, in addition to realignment, may be indicated for @entity1 with severe @entity1844 . This study demonstrated that the modified Roux-Goldthwait procedure, without advancement of the tibial attachment of the patellar ligament, can stabilize the patella without increasing patellofemoral compression. The procedure does not relieve the symptoms of severe @entity1844 of the patella but realignment is the first step in treatment of any form of patellofemoral @entity4040 .
