The 'three-in-one' surgical procedure for habitual dislocation of the patella in children and adolescents provides functional knee improvement without recurrences at mid-term follow-up: a retrospective case series.

PURPOSE: To introduce the 'three-in-one' surgical procedure, and to report its clinical outcomes.

METHODS

This retrospective clinical study included 42 skeletally immature patients with habitual patellar dislocation who underwent a 'three-in-one' surgical procedure from 2017 to 2022. This procedure comprised an extensive lateral release, half medial transfer of patellar tendon with subperiosteal fixation, and reconstruction of the medial patellofemoral ligament with semitendinosus autograft. The clinical results were evaluated using preoperative and postoperative functional score and imaging.

RESULTS

All patients returned for follow-up at a mean of 52.1 ± 9.2 months after surgery. There was no recurrence of dislocation or severe complications. All the patients have resumed full activities with satisfactory knee function. There was a statistically significant improvement in knee function scores. Abnormal tracking remained in two patients (4.8%).

CONCLUSION

The modified 'three-in-one' surgical procedure is effective and safe in treating habitual dislocation in adolescents.