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The aim of this study is to answer the question whether a modified, minimally invasive Madigan/Insall operation is an appropriate treatment for acute or recurrent patellar dislocations. Between January 1, 2002 and June 30, 2005 a total of 56 patients with acute and chronic patellar dislocations were operated. The patients underwent follow-up examinations between 8 and 19 months postoperatively. Their subjective satisfaction with the result was assessed (according to Larsen and Lauridsen). 34 of the operated patients (94%) were available for follow-up. 28 of them had a good, 3 a satisfactory and 3 a poor subjective result. No re-dislocation occurred. A large number of operative techniques has been described for the treatment of acute and recurrent patellar dislocation. In our opinion, a minimally invasive operative technique, in which the patella is actively stabilized by the vastus medialis muscle, has decisive advantages compared to conventional techniques.

In the clinic of Nuernberg between 1999 - 2002 55 patients were treated by ligament reconstruction after patellar dislocation, 43 could be reviewed. In 23 cases patients reached our clinic as first time dislocators, 20 after multiple dislocations (1 - 15). In 3 cases only arthroscopy was done, in 40 cases with an additional medial ligament reconstruction, in 11 cases combined with lateral release. In follow-up examination redislocation rate was 9%, only concerning habituell dislocations. According to Lysholm score 70% of the patients showed more than 90 points out of 100, according to Larsen and Lauridsen score 81% had excellent to good results. We recommend arthroscopy after patellar dislocations, if necessary combined with medial ligament reconstruction and lateral release.