Management of patellar instability in skeletally immature patients
EFORT Open Reviews, vol.9, no.1, pp.60-68, 2024 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 9 Issue: 1
- Publication Date: 2024
- Doi Number: 10.1530/eor-23-0070
- Journal Name: EFORT Open Reviews
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.60-68
- Keywords: femoral anteversion, medial patellofemoral ligament reconstruction, patellar dislocation, patellar instability
- Istanbul University-Cerrahpasa Affiliated: No
Abstract
• Surgical intervention is the treatment of choice for recurrent lateral patellar instability. • Surgery should be considered for first time lateral patella dislocations with osteochondral fractures or underlying anatomical risk factors. • Primary repair and nonanatomical imbrications/reconstructions have fallen out of favor due to abnormal biomechanics and high rates of recurrence. Anatomical reconstruction of the MPFL using a variety of auto and allograft tissues have yielded good outcomes and low redislocation rates. • Physeal sparing MPFL reconstruction techniques under radiological control are safe and do not cause growth disturbance. Allografts may be indicated for hyperlax patients. • Although no clear cutoff points exist, correction of valgus and excessive femoral anteversion should be considered when indicated. • Osteochondral and chondral injuries are common and should be addressed during surgery for instability.