The Journal of Bone and Joint Surgery, Vol 68, Issue 3 405-413, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Instability of the patellofemoral joint in Down syndrome
TW Dugdale and TS Renshaw
The knees of 210 institutionalized patients with Down syndrome were
evaluated to determine the prevalence of patellofemoral instability and to
assess the value of orthotic and surgical treatment. The cases of 151
non-institutionalized patients with Down syndrome were also reviewed. The
patella was dislocatable or dislocated in thirty-five knees (8.3 per cent)
in the institutionalized group and in twelve knees (4.0 per cent) in the
non-institutionalized group. This interfered with walking in some patients,
but only three of the patients were unable to walk because of
patellofemoral instability. None of the institutionalized patients used any
form of orthosis, and only three non-institutionalized patients used an
orthosis. Eight knees in five patients had been operated on, and they had
an average length of follow-up of 16.8 years. Four of these knees had a
satisfactory result. Instability of the patellofemoral joint may occur in
patients with Down syndrome but is rarely disabling. Almost all patients
with patellofemoral instability adapted to the problem and were able to
walk.