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Acute dislocation of the patella is common on the lateral side of the knee. Intra-articular dislocations in which the patella is turned around on its horizontal axis are infrequent. Approximately 35 cases have been reported in the world literature.
This article presents an intra-articular horizontal dislocation of the patella, which was found during a clinical work-up with no ligamentous or quadriceps tendon injuries.
Case Report
An 87-year-old woman presented after sustaining a fall while walking. Her knee had suddenly given way while stepping down from die sidewalk, causing her to fall backwards. When she tried to get up she observed tumefaction of die anterior pars of the left knee, and she was unable to complete flexion and extension. She experienced pain and functional impotence while attempting to bear weight on the limb.
On examination, the leg was semiextended and a hematoma and bulge of the anterior aspect of die knee and dip just proximal to the patella were noted. Initial diagnosis was rupture of die quadriceps. Movements at die joint were restricted; however, the patient could raise die leg straight and the prominence of the patella was noted.
Radiographs revealed a dislocated patella with the articular surface facing distally (Figure 1). No osteochondral injuries were evident. Reduction was achieved by gentle manipulation with no anestiietic (Figure 2). Initial gradual flexion up to 110° was performed followed by gradual extension of the knee. Direct...