Mid to Long Term Evaluation of Elmslie-Trillat-Marquet procedure for Recurrent Patellar Subluxation or Dislocation

PURPOSE: To evaluate mid to long term results of Elmslie-Trillat-Marquet procedures for recurrent patellar subluxation or dislocation. MATERIALS AND METHODS: From May 1993 to February 2004, 21 knees in 20 patients who got Elmslie-Trillat-Marquet procedures were evaluated. Mean follow-up periods were 80.5 months. Clinical tests such as Lysholm knee scoring scale, IKDC subjective knee evaluation form, visual analog scale and radiological tests such as Insall-Salvati index and congruence angle were evaluated. RESULTS: Lysholm knee score was improved to average 91 points, IKDC knee score 82, visual analog scale 28. Q angle was improved from average 28degrees preoperatively to 12.5degrees. Insall-Salvati index and congruence angle were significantly corrected and no subluxation or dislocation were observed at final follow up. Fracture of tibial tubercle in 1 case which was treated with refixation and medial instability in 3 cases were observed. CONCLUSION: Elmslie-Trillat-Marquet procedure can be a useful method to correct patellofemoral malalignment in long term follow up but meticulous care to reduce the complication was needed.

Evaluation of the Elmslie-Trillat-Marquet Procedure for Recurrent Patellar Subluxation or Dislocation / 대한정형외과학회잡지

PURPOSE: To assess the clinical and radiographic results of the Elmslie-Trillat-Marquet procedure used to treat recurrent patellar subluxation or dislocation with patellar malalignment. MATERIALS AND METHODS: A total of 15 knees in 14 patients were evaluated at an average of 54.5 months (12 to 106) following the Elmslie-Trillat-Marquet procedure; carried out between May 1993 and March 2000. The evaluation included subjective, objective and radiographic assessments. RESULTS: The causes of recurrent patella dislocation were patella alta (11 knees), tight lateral retinaculum (8 knees), patella dysplasia (7 knees), femoral condyle dysplasia (13 knees) and joint hyperlaxity (1 case). The average preoperative Q-angle was 28.5degrees and the postoperative angle 13 degrees. Subjective evaluation using Cox's criteria showed excellent or good results in 13 knees (87%), and the objective evaluation using Fulkerson's functional knee score showed excellent or good results in 14 knees (93%). The mean anterior tibial tubercle displacement was 8 mm (7-11 mm), and the patella congruence angle and Insall-Salvati index were significantly corrected (p<0.001). Lateral subluxation and patellar tilt angle were corrected in all cases. The only complication was an irritation due to nonabsorbable suture material. There were no redislocations, infections, nonunions, or fractures of the transferred tibial tubercle during the follow-up period. CONCLUSION: The Elmslie-Trillat-Marquet procedure for recurrent patellar subluxation or dislocation can basically correct malalignment tridimensionally.