140 THE JOURNAL OF BONE AND JOINT SURGERY THE NATURAL HISTORY OF RECURRENT DISLOCATION OF THE PATELLA LONG-TERM RESULTS OF CONSERVATIVE AND OPERATIVE TREATMENT

From 1970 to 1978, 29 patients had a unilateral operation for bilateral recurrent dislocation of the patella. We examined 21 of them at a mean of 14 years postoperatively. Eighteen of these patients had evidence of g#{233}neralisedjoint laxity. Six of the operated knees and four of the unoperated knees still had recurrent dislocations. The operated knees were clinically worse, with a significantly higher incidence of osteoarthritis. We concluded that the operations used to treat recurrent dislocation of the patella may have had short-term benefits, but did not cure the patients in the long term. There is concern about the incidence of postoperative recurrence and of degenerative changes after operations for recurrent dislocation of the patella (Hampson and Hill 1975; Crosby and Insall 1976; Juliusson and Markhede 1984). The fact that more than 100 different surgical techniques have been described also indicates that the results tend to be unsatisfactory and a conserva-tive approach is still considered to be a valid alternativ