Obligatory Patella Dislocation with Severe Valgus Knee Deformity Treated with Neutral-Wedge Distal Femoral Osteotomy (DFO) And Medial Patello-Femoral Ligament (MPFL) Reconstruction

Abstract

A 19 years old male patient has a chief complaint in the right knee that was worsening for about 2 years accompanied with obligatory dislocation of the patella and genu valgus deformity of the right leg. Obligatory dislocation of the patella is a condition where the patella dislocates completely with each flexion and extension cycle of the knee and the patient has no control over the patella that dislocates. Medial Patello-Femoral Ligament (MPFL) injury is the main cause of this condition and often associated with genu valgus. Several surgery methods are combined to reconstruct this condition. The most common methods used are MPFL reconstruction with DFOs as realignment procedures for knee valgus deformity. In this patient, we performed Neutral-Wedge Distal Femoral Osteotomy as a choice to realign the genu valgus of the right knee followed with MPFL reconstruction. Although patient in this case showed improvement after 90 days of procedure and physiotherapy, the general outcome of Neutral-Wedge Distal Femoral Osteotomy remains unconfirmed as insufficient studies exist about the method. Encouragement of this procedure in the future to gain more result is important for the interest of comparing and contrasting the data.