18 year old male, a basketball player presented with right anterior knee pain and frequent subluxations and dislocation of the patella since 5 months. To start with he fell down and twisted his knee while playing basketball for which he visited an orthopedician and was diagnosed to have right patella dislocation that was treated by immobilization in a cylindrical cast for 4 weeks. He returned to sports after the primary episode but experienced frequent anterior knee pain and multiple episodes of patellar subluxations and dislocations that is, 6 episodes of frank dislocations while playing which were reduced by his coach. The patient was evaluated in the OPD, he had severe anterior knee pain, tenderness over medial patellofemoral joint, a positive apprehension test, no hyperlaxity and a Q-angle of 14°. Radiographs showed lateral patellar tilt [], lateral patellar subluxation, Insall-Salvatti Index-1, sulcus angle 140°. MRI showed effusion of knee joint with tear in the MPFL at the patellar attachment []. Of note, he had no other frank knee injuries or surgeries performed on the same knee. A preprocedure arthroscopy showed patellofemoral joint maltracking but no chondromalacia of patella.\nThe patient was treated definitively with MPFL reconstruction by the technique described by us. He returned to practice in 3 months and professional sports in 4 months, at 24-month followup, Modified Crosby and Insall scale was excellent and Kujala score was 98.
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.