ArticleArchives of orthopaedic and trauma surgery2020
High failure rate 10.8 years after vastus medialis transfer and lateral release (Green's quadricepsplasty) for recurrent dislocation of the patella.
Article in Archives of orthopaedic and trauma surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- Patellofemoral Instability in Children with Down Syndrome.Journal of the Pediatric Orthopaedic Society of North America · 2026Review
- Quadricepsplasty for Patellar Obligate (Habitual) Lateral Flexion Dislocation.Arthroscopy techniques · 2025Article
- Modified Langenskiöld procedure for congenital patella dislocations in pediatric patients.BMC musculoskeletal disorders · 2022Article
- A Prospective Cohort Study on Quality of Life among the Pediatric Population after Surgery for Recurrent Patellar Dislocation.Children (Basel, Switzerland) · 2021Article
- Modified Langenskiöld procedure for chronic, recurrent, and congenital patellar dislocation.Journal of children's orthopaedics · 2020Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn adolescent patients with recurrent patellar dislocation, the Green's quadricepsplasty stabilizes the patella in a combination of a lateral release, a transfer of the medial head of the quadriceps onto the lateral part of the patella and an imbrication of the medial patellar retinaculum and joint capsule. This study aimed to evaluate the long-term performance, considering re-dislocations and functional outcomes. We hypothesized a high failure rate in the long term.
methodsIn this single surgeon and single center study 26 knees in 23 patients (mean age 14.2 years; 4-22 years, 18 females) with recurrent patellofemoral dislocation underwent a vastus medialis transfer, medial reefing and lateral release as it was described by Green in 1965 with a mean follow-up 10.8 years (6-24 years). Clinical assessment was carried out with an IKDC-score (international knee documentation committee) and a self-assessment for each knee separately. The radiologic evaluation included measurement of the patella height, the grade of trochlear dysplasia and the sulcus angle.
resultsIn 12 of 26 cases (46.2%) the patella did not re-dislocate after vastus medialis transfer and lateral release. In 11 of 26 cases (42.3%), the patients described the function of their knees as normal or nearly normal according to IKDC after the surgical treatment without any re-dislocation. In 14 of 26 cases (53.8%), the patella re-dislocated. 7 of these 14 cases underwent a revision operation. Re-dislocations occurred after a mean interval of 21 months after the index procedure. In only 2 of 26 cases (7.7%) the patients returned to sports.
conclusionGreen's procedure to stabilize patellofemoral instabilities results in a high failure rate on the long-term and low subjective assessments. We do not recommend performing vastus medialis transfer, medial imbrication and lateral release as a standalone technique. LEVEL OF EVIDENCE: IV.
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