Management of patellar instability in skeletally immature patients

Sahin E., Tandogan R., Liebensteiner M., Demey G., Kayaalp A.

EFORT Open Reviews, cilt.9, sa.1, ss.60-68, 2024 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 9 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1530/eor-23-0070
  • Dergi Adı: EFORT Open Reviews
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.60-68
  • Anahtar Kelimeler: femoral anteversion, medial patellofemoral ligament reconstruction, patellar dislocation, patellar instability
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

• 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.