Management of patellar instability in skeletally immature patients
EFORT Open Reviews, cilt.9, sa.1, ss.60-68, 2024 (SCI-Expanded, Scopus)
- 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.