Patella Dislocation in Children and Adolescents.

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Patellar dislocation is a common knee injury in adolescents.
• Underestimation of anatomical and functional factors influences treatment strategies, particularly for recurrent cases.

Purpose of the Study:

• To analyze treatment outcomes for patellar dislocations.
• To evaluate the impact of anatomical factors on therapeutic strategies.
• To compare outcomes of conservative versus surgical interventions.

Main Methods:

• Retrospective analysis of 88 patients with 136 patellar dislocations (2000-2015).
• Assessment of anatomical conditions using X-ray and MRI.
• Evaluation of treatment results, including conservative (immobilization) and surgical (MPFL reconstruction/tightening) approaches.

Main Results:

• Anatomical predisposition was present in nearly all cases, with significant differences in sulcus angle, patellar/trochlear dysplasia, and patellar height compared to controls.
• Recurrence rates were 41.7% for conservative treatment and 29.6% for surgical treatment (excluding MPFL tendon graft reconstruction).
• No recurrences were observed after medial patellofemoral ligament (MPFL) reconstruction with a tendon graft.

Conclusions:

• Anatomical predisposition is common in patellar dislocations, often triggered by sports.
• Conservative treatment is suitable for primary dislocations without severe concomitant injuries.
• Surgery is indicated for recurrent dislocations, osteochondral fractures, and MPFL reconstruction with tendon grafts shows promising results in preventing recurrence.