Abstract / Summary
Neglected lateral patellar dislocation, characterised by sustained lateral displacement beyond three weeks, is a multifaceted syndrome marked by progressive periarticular fibrosis, adaptive shortening, and osteochondral injury, leading to discomfort, instability, and functional limitations. This case report illustrates the management of neglected lateral patellar dislocation with displaced osteochondral fracture accompanied by Dejour type D trochlear dysplasia in a young male complicated by Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Surgical intervention was postponed for six weeks because of PE, requiring anticoagulant therapy. Subsequent to the partial clearance of the thrombus, the patient underwent single-stage surgery that included fixing of the osteochondral fragment, deepening of the sulcus using trochleoplasty, lengthening of the lateral retinaculum, and reconstruction of the medial patellofemoral ligament using a gracilis autograft. Postoperative therapy involved early full weight-bearing and range of motion exercises, resulting in positive early outcomes at two weeks, including 0°-60° knee flexion and one-year follow-up demonstrating pain-free knee ROM 0°-120° and return to daily activity at six weeks and resumed work at eight weeks. This example underscores the essential need for a customised therapy strategy that effectively addresses both soft tissue and bony pathology, even when surgery timing is confounded by significant systemic concerns, to attain favourable functional outcomes.