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Insall proximal realignment for disorders of the patella.

Proximal realignment with standard lateral retinacular release (Insall operation) was performed on 35 knees with a follow-up time of two to 11 years. The results for chondromalacia patellae were satisfactory to excellent results in 20 of 23 knees (87%) at two years and in eight of 15 knees (55%) at five to 11 years. Satisfactory to excellent results in 11 of 12 knees (92%) were noted for recurrent patellar dislocation. This procedure should be reserved for advanced chondromalacia patellae (Grades III and IV) and recurrent patellar dislocation. Anatomic studies suggest that the pain relief was most likely due to a combination of patellar denervation and restoration of patellar congruence.