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Soft-tissue realignment for adolescent patellar instability.

R E McCall1, V Ratts

  • 1Shriners Hospitals for Children, Shreveport, Louisiana 71101, USA.

Journal of Pediatric Orthopedics
|July 21, 1999
PubMed
Summary
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Soft-tissue realignment effectively treats adolescent patellar instability, offering good to excellent long-term outcomes. This procedure avoids bone cuts, providing a successful alternative for young patients experiencing knee instability.

Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Sports medicine

Background:

  • Patellar malalignment and instability are common in adolescents.
  • Surgical correction often involves tibial tubercle osteotomies.
  • Soft-tissue realignment is an alternative approach.

Purpose of the Study:

  • To evaluate the long-term effectiveness of the Insall proximal-distal soft-tissue realignment for adolescent patellar instability.
  • To assess outcomes including stability, strength, range of motion, and patellar congruence.

Main Methods:

  • A retrospective study of 54 patients (65 knees) who underwent Insall realignment between 1980 and 1996.
  • No concomitant bony or other soft-tissue procedures were performed.
  • Average follow-up was 6 years (range, 2-15 years), with assessments of clinical outcomes and Merchant's view congruence angle.

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Main Results:

  • 87% of patients achieved good to excellent results.
  • 8% had fair results, and 5% had poor results.
  • The procedure demonstrated satisfactory long-term effectiveness in the skeletally immature population.

Conclusions:

  • Insall proximal-distal soft-tissue realignment is an effective treatment for adolescent patellar instability.
  • The procedure provides good to excellent long-term outcomes without the need for osteotomies.
  • This technique offers a viable surgical option for pediatric patients with persistent patellar instability.