Congenital Deformity of the Knee Joint: A Boy With Congenital Patella Alta

  • Ramin Zargarbashi Department of Orthopedics and Trauma Surgery, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Saeed Shakiba Department of Orthopedics and Trauma Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Farbod Yousefi Department of Orthopedics and Trauma Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohammad Hossein Nabian Department of Orthopedics and Trauma Surgery, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Behnam Panjavi Mail Department of Orthopedics and Trauma Surgery, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Congenital patella alta, Open reduction, Operative treatment

Abstract

Introduction: Patella alta is an extremely rare condition, refers to an abnormally high position of the patella. Surgical treatment of habitual dislocation of the patella aims at a step-by-step correction of the abnormality.
Case Presentation: A 4-year-old boy presented with a rare superior dislocation of the patella. Clinical examination and radiographs confirmed the dislocation of the patella. The patella was reduced with proper reduction technique under sedation, resulting in the improvement of active range of motion.
Conclusion: Congenital patella alta is a rare deformity in children. Treatment and diagnosis in the early stages are of our priority in the treatment. Our non-surgical treatment is our preferred treatment in this patient. The surgical treatment approach is performed in patients that have no response to non-surgical treatments.

References

[1] Hanspal R. Superior dislocation of the patella. Injury. 1985; 16(7):487-8. [DOI:10.1016/0020-1383(85)90176-7]
[2] Cusco X, Seijas R, Ares O, Cugat JR, Garcia-Balletbo M, Cugat R. Superior dislocation of the patella: A case report. Journal of Orthopaedic Surgery and Research. 2009; 4:29. [DOI:10.1186/1749- 799X-4-29] [PMID] [PMCID]
[3] Bassi RS, Kumar BA. Superior dislocation of the patella; a case report and review of the literature. Emergency Medicine Journal. 2003; 20(1):97-8. [DOI:10.1136/emj.20.1.97] [PMID] [PMCID]
[4] Wood L, Stirrat AN. Superior dislocation of the patella: A case report and review of the literature. The Knee. 1998; 5(4):299-300. [DOI:10.1016/S0968-0160(98)00002-7]
[5] Berg EE, Mason SL, Lucas MJ. Patellar height ratios: A comparison of four measurement methods. The American Journal of Sports Medicine. 1996; 24(2):218-21. [DOI:10.1177/0363546596024002 18] [PMID]
[6] Hasler CC, Studer D. Patella instability in children and adolescents. EFORT Open Reviews. 2016; 1(5):160-6. [DOI:10.1302/2058- 5241.1.000018] [PMID] [PMCID]
[7] Cohen SL, Reilly EB. Congenital unilateral superior dislocation of the patella. United States Armed Forces Medical Journal. 1952; 3(4):655-6. [PMID]
[8] van der Krogt MM, Bregman DJJ, Wisse M, Doorenbosch CAM, Harlaar J, Collins SH. How crouch gait can dynamically induce stiffknee gait. Annals of Biomedical Engineering. 2010; 38(4):1593-606. [DOI:10.1007/s10439-010-9952-2] [PMID] [PMCID]
[9] Kannus PA. Long patellar tendon: Radiographic sign of patellofemoral pain syndrome--a prospective study. Radiology. 1992; 185(3):859-63. [DOI:10.1148/radiology.185.3.1438776] [PMID]
[10] Shabshin N, Schweitzer ME, Morrison WB, Parker L. MRI criteria for patella alta and baja. Skeletal Radiology. 2004; 33(8):445-50. [DOI:10.1007/s00256-004-0794-6] [PMID]
[11] Ward SR, Terk MR, Powers CM. Influence of patella alta on knee extensor mechanics. Journal of Biomechanics. 2005; 38(12):2415-22. [DOI:10.1016/j.jbiomech.2004.10.010] [PMID]
[12] Simmons E, Cameron JC. Patella alta and recurrent dislocation of the patella. Clinical Orthopaedics and Related Research. 1992; 274:265-9. [PMID]
[13] Ma FYP, Selber P, Nattrass GR, Harvey AR, Wolfe R, Graham HK. Lengthening and transfer of hamstrings for a flexion deformity of the knee in children with bilateral cerebral palsy: Technique and preliminary results. The Journal of Bone and Joint Surgery British Volume. 2006; 88-B(2):248-54. [DOI:10.1302/0301-620X.88B2.16797] [PMID]
[14] Hosny GA, Fadel M. Managing flexion knee deformity using a circular frame. Clinical Orthopaedics and Related Research. 2008; 466(12):2995-3002. [DOI:10.1007/s11999-008-0530-y] [PMID] [PMCID]
[15] Ullmann Y, Fodor L, Soudry M, Lerner A. The Ilizarov technique in joint contractures and dislocations. Acta Orthopaedica Belgica. 2007; 73(1):77-82. [PMID]
[16] Klatt J, Stevens PM. Guided growth for fixed knee flexion deformity. Journal of Pediatric Orthopaedics. 2008; 28(6):626-31. [DOI:10.1097/BPO.0b013e318183d573] [PMID]
[17] Palocaren T, Thabet AM, Rogers K, Holmes Jr L, Donohoe M, King MM, et al. Anterior distal femoral stapling for correcting knee flexion contracture in children with arthrogryposis-preliminary results. Journal of Pediatric Orthopaedics. 2010; 30(2):169-73. [DOI:10.1097/BPO.0b013e3181d07593] [PMID]
[18] Stevens PM, Maguire M, Dales MD, Robins AJ. Physeal stapling for idiopathic genu valgum. Journal of Pediatric Orthopaedics. 1999; 19(5):645. [DOI:10.1097/01241398-199909000-00018] [PMID]
[19] Beals RK. Treatment of knee contracture in cerebral palsy by hamstring lengthening, posterior capsulotomy, and quadriceps mechanism shortening. Developmental Medicine & Child Neurology. 2001; 43(12):802-5. [DOI:10.1111/j.1469-8749.2001.tb00166.x] [PMID]
Published
2020-07-12
How to Cite
1.
Zargarbashi R, Shakiba S, Yousefi F, Nabian MH, Panjavi B. Congenital Deformity of the Knee Joint: A Boy With Congenital Patella Alta. CRCP. 5(1):5-10.
Section
Case Report(s)