Patellar tendon post Roux-Goldthwait procedure for recurrent dislocation: "cross-over" tendon

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

PH of recurrent patellar dislocation as young woman. "Stabilization" procedure 30 years ago. Now anterior knee pain.

Patient Data

Age: 50
Gender: Female

Split and twisted patellar tendon that is reattached to the tibial tuberosity. Patellar alignment is central to the trochlea but there is marked loss of articular cartilage medially.

Case Discussion

This procedure involves medial transfer of the lateral patellar tendon i.e. the lateral 1/2 of the patellar tendon is split and detached from the tibial tuberosity, passed beneath the medial tendon and reattached on the medial side of the medial 1/2 (onto the tuberosity). This acts to realign the patella medially (preventing lateral dislocation). It produces a "cross-over" appearance on MRI. It is an older operation (not commonly performed these days) but is still seen as many patients were children or young adults at the time of surgery.

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