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Review
. 2018 Jun;11(2):172-181.
doi: 10.1007/s12178-018-9472-5.

Patellar Instability in the Skeletally Immature

Charles A Popkin  1 , Ahmad F Bayomy  2 , Evan P Trupia  2 , Charles M Chan  3 , Lauren H Redler  2
Affiliations
Review

Patellar Instability in the Skeletally Immature

Charles A Popkin et al. Curr Rev Musculoskelet Med. 2018 Jun.

Abstract

Purpose of review: This review will focus on the evaluation and management of patellar instability in the developing patient.

Recent findings: A large number of surgical techniques have been described to prevent recurrent patellofemoral instability in the pediatric population, including both proximal and distal realignment procedures. The wide variety of treatment options highlights the lack of agreement as to the best surgical approach. However, when a comprehensive exam and workup are paired with a surgical plan to address each of the identified abnormalities, outcomes are predictably good. Patellar instability is a common knee disorder in the skeletally immature patient that presents a unique set of challenges. Rates of re-dislocation in pediatric and adolescent patients are higher than in their adult counterparts. Careful consideration of the physeal and apophyseal anatomy is essential in these patients. While the majority of primary patellar instability events can be treated conservatively, multiple events often require surgical intervention.

Keywords: Growth plate; Guided growth; MPFL; Modified Grammont; Pediatric patellar instability.

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Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
a, b Axial and sagittal image of recent patellar dislocation MRI in a 12-year-old girl. Note the lipohemarthrosis and the osteochondral injury involving the lateral femoral condyle (sagittal view)
Fig. 2
Fig. 2
Proximal reconstructions (all artwork original and drawn by Evan Trupia, MD). a MPFL. b Adductor sling. c Quadriceps turndown/HemiQuad
Fig. 3
Fig. 3
Distal reconstructions. Galeazzi Procedure
See this image and copyright information in PMC

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