Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    
Login 

Users Online: 196 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 53  |  Issue : 1  |  Page : 122-127

Modified roux-goldthwait procedure for management of patellar dislocation in skeletally immature patients with down syndrome


Department of Orthopaedics, Children's Hospital “Bambino Gesù,” Rome, Italy

Correspondence Address:
Dr. Fabrizio Donati
Department of Orthopaedics, Children's Hospital “Bambino Gesù,” Via Della Torre di Palidoro, Rome
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ortho.IJOrtho_505_17

Rights and Permissions

Background: Patellar instability is a common problem in Down syndrome patients since their childhood. Several treatment have been proposed, but relapses are frequent and not all surgeries are suitable for growing patients. The aim of the present study is to evaluate the clinical and radiographic outcomes of a modified Roux-Goldthwait technique, for the management of patellar instability in children with Down syndrome at minimum 5-year followup. Materials and Methods: 19 patients (23 knees) affected by Down syndrome surgically treated for patellar dislocation, between 2000 and 2012 were included in this study. The mean age of patients was 9.5 years (range 3.7 – 15 years) and had a Dugdale Grade III, IV, and V patellar dislocation. Trochlear groove dysplasia was present in 15 patients. Each patient was clinically evaluated considering relapse rate, pre- and postoperative range of motion (ROM), Kujala score, and modified Lysholm score. Radiographic examination was performed on standard X-ray considering patellar height, trochlear angle, and patellofemoral congruence angle. Results: The mean followup was 134 months (range 62–206 months). No case of relapse of dislocation was registered with an improved ROM (significant for knee extension, P < 0.05). The Kujala score showed significant improvement from a mean preoperative value of 39 ± 6.3 to a mean postoperative value of 92.7 ± 3.4 (P < 0.05) at final followup such as the modified Lysholm score (from mean preoperative 55.6 ± 6.3 to mean postoperative of 94.2 ± 2.6). Radiographs performed at latest followup showed a tendency to normalization of all the parameters considered, with a restored patellofemoral congruence and trochlear groove shape and without signs of osteoarthritis. Conclusion: The present study showed that the Roux-Goldthwait procedure is a valid surgical option for the treatment of patellar dislocation in children with Down syndrome.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed47    
    Printed0    
    Emailed0    
    PDF Downloaded6    
    Comments [Add]    

Recommend this journal