Related Experiment Video
Updated: May 11, 2026
05:34
A Mini-Invasive Internal Fixation Technique for Studying Immobilization-Induced Knee Flexion Contracture in Rats
Published on: May 20, 2019
Treating patella instability in skeletally immature patients
Patrick Vavken1, Matthias D Wimmer, Carlo Camathias
1Department of Orthopaedic Surgery, University Hospital Basel, Basel, Switzerland. patrick.vavken@childrens.harvard.edu
Summary
For acute patellar dislocation in young patients, surgery is not superior to conservative treatment. Recurrent instability in pediatric and adolescent patients benefits most from medial patellofemoral ligament (MPFL) reconstruction.
Area of Science:
- Orthopaedic Surgery
- Pediatric Orthopaedics
- Sports Medicine
Background:
- Patellar instability is a common condition in immature and adolescent patients.
- Treatment strategies vary, necessitating a review of current evidence for optimal outcomes.
- Understanding the efficacy of different orthopaedic interventions is crucial for this patient population.
Purpose of the Study:
- To systematically review existing evidence on orthopaedic treatments for acute and chronic patellar instability in pediatric and adolescent patients.
- To evaluate the effectiveness of conservative versus surgical interventions.
- To assess the safety and outcomes of surgical patellar stabilization in immature patients.
Main Methods:
- Systematic review of studies identified through comprehensive searches of major medical databases (PubMed, CINAHL, EMBASE, Cochrane).
- Inclusion of all available dates and languages.
- Level IV evidence, based on a review of mixed-level studies.
Main Results:
- Analysis included 20 articles covering 456 knees in 425 patients.
- No significant difference in outcomes between conservative and surgical treatment for acute patellar dislocations after 7-14 years.
- Surgical stabilization showed consistent benefits for recurrent instability regarding clinical scores, stability, and radiographic assessment, with no evidence of growth disturbance.
Conclusions:
- Current evidence does not favor surgical over conservative treatment for acute patellar dislocations.
- Anatomic variations should guide treatment decisions.
- Medial patellofemoral ligament (MPFL) reconstruction is the most effective and safe surgical option for recurrent patellar instability in pediatric and adolescent patients with normal or corrected knee anatomy.
Related Concept Videos
01:16Bones of the Lower Limb: Femur and Patella
The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the neck...
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...