Patella instability in children and adolescents

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Sports Medicine

Background:

• Patellar instabilities are common knee pathologies in growing individuals.
• Congenital patellar dislocations are rare but require early intervention.
• Conservative management is preferred for first-time traumatic dislocations, while recurrent cases or those with anatomical factors necessitate surgical evaluation.

Purpose of the Study:

• To review the management strategies for patellar instability in children and adolescents.
• To outline the diagnostic approach and decision-making process for surgical intervention.
• To discuss surgical techniques and their indications in skeletally immature patients.

Main Methods:

• Review of current literature on pediatric patellar instability.
• Analysis of diagnostic tools including standard radiographs and MRI.
• Evaluation of surgical reconstruction techniques for patellar realignment.

Main Results:

• Decision-making for surgical realignment involves assessing trochlear groove, cartilage, and medial patello-femoral ligament (MPFL) integrity.
• Correction of anatomical factors like femoral anteversion and patella alta is crucial.
• Soft tissue procedures in skeletally immature patients can provide stability or delay definitive bony procedures.

Conclusions:

• Management of patellar instability in pediatric populations is multifactorial, considering age, etiology, and anatomical factors.
• Accurate diagnosis and tailored surgical planning are essential for successful outcomes.
• Soft tissue procedures play a vital role in managing instability during skeletal immaturity.