26 year old man who is a railway employee presented with left anterior knee pain and frequent dislocation of the patella since 3 months. To start with he fell down and twisted his knee while climbing down a ladder for which he visited a physician and was diagnosed to have left patella dislocation that was treated by immobilization in a long leg knee brace for 3 weeks. He had frequent anterior knee pain and frequent dislocations of the patella (probably 6) which were less painful than the primary episode and were self reducible. The patient was evaluated in the OPD, there was diffuse swelling and tenderness over medial patellofemoral joint, a positive apprehension test, no hyperlaxity and a Q-angle of 15°. Radiographs showed lateral patellar tilt, lateral patellar subluxation, sulcus angle 136° [] and Insall-Salvatti Index-1.1 []. MRI showed efussion of knee joint with tear in the MPFL at the patellar attachment. Of note, he had no other surgeries performed to the same knee. A preprocedure arthroscopy showed patellofemoral joint maltracking.\nThe patient was treated definitively with MPFL reconstruction by the technique described by us. He returned to work in 6 weeks, at 24-month follow up, Modified Crosby and Insall scale was excellent and Kujala score was 95.
27 year old man who is a typist by profession presented with right anterior knee pain and frequent dislocations of the patella since four and a half months. To start with he fell down and twisted his knee while climbing down a staircase after which he had a patellar dislocation, the dislocation was self reduced with minimal knee manipulation. He later experienced 4 episodes of knee dislocations and consistent anterior knee pain. There was tenderness over medial patellofemoral joint, a positive apprehension test, no hyperlaxity and a Q angle of 12°. Radiographs showed lateral patellar tilt, lateral patellar subluxation, Insall-Salvatti Index-1, sulcus angle 142°. MRI showed effusion of knee joint with tear in the MPFL at the femoral attachment []. Of note, he had no other surgeries performed to the same knee. A preprocedure arthroscopy showed patellofemoral joint maltracking.\nThe patient was treated definitively with MPFL reconstruction by the technique described by us. He returned to work in 6 weeks, at 24-month follow up, Modified Crosby and Insall scale was excellent and Kujala score was 96.