Bilateral Patellofemoral Recurrent Instability Treatment in a Type 1 Arnold-Chiari Malformation Patient
I.G.N. Reis, S.L. Mendes, J.V.C. Xavier, P.V. Rezende, G.M.D.A.E. Silva, M.A.P. De AndradeObjectives:
Describe the surgical treatment outcomes in a Type 1 Arnold-Chiari malformation patient with bilateral patellofemoral instability.
Methods:
This study presents a case report with prospective follow-up of a 19-year-old female patient with Arnold–Chiari malformation type I who underwent surgical treatment for recurrent bilateral patellofemoral dislocation. The condition was associated with medial patellofemoral ligament insufficiency, high-grade trochlear dysplasia, and genu valgum.
Results:
Bilateral surgical treatment was performed, consisting of trochleoplasty, high tibial varus-producing osteotomy (medial closing-wedge osteotomy), and medial patellofemoral ligament reconstruction. Postoperatively, successful correction of bilateral patellofemoral instability was achieved, also important improvements in functional outcomes and quality of life were observed at the 9-month follow-up.
Conclusions:
Surgical management of recurrent patellofemoral instability, addressing both primary and secondary risk factors, is effective in patients with Arnold–Chiari malformation Type I. Therefore, a meticulous and systematic preoperative evaluation is essential to minimize complications and optimize outcomes.