Abstract
Patellar instability is a common pathology of the knee in pediatric patients. The management of this condition can be a challenge for the orthopedic surgeon, and a comprehensive understanding of the anatomy and biomechanics of the structures around the knee is of utmost importance in formulating a treatment plan. Predisposing factors can be related to: trochlear and patellar morphological abnormalities, ligamentous stabilizers, limb geometries in the axial plane, and patellar height abnormalities. Traditionally, first-time dislocators have been treated non-operatively; however, recent evidence suggests that certain factors are related to recurrent instability, and surgical treatment may be considered even after the first dislocation. It is important to keep in mind that younger children with open physes are not suitable candidates for certain surgical techniques. In this comprehensive review, we aimed to focus on the most up-to-date information on this topic and emphasize the importance of individualizing the treatment of pediatric patients.
Highlights
Patellar instability is one of the most common knee pathologies in the skeletally immature population and comprises several different conditions, such as acute dislocations, subluxations, recurrent instability episodes, and congenital dislocations
The purpose of this review is to summarize the current knowledge on the pathophysiology, evaluation, and treatment of pediatric patellar instability
Osteology 2021, 1 the patella and femur is necessary for the healthy development of both the trochlea and patella, as evident by the trochlear dysplasia seen in rabbits after patellar dislocation [17]
Summary
Patellar instability is one of the most common knee pathologies in the skeletally immature population and comprises several different conditions, such as acute dislocations, subluxations, recurrent instability episodes, and congenital dislocations. More than 30% of the patients with an acute dislocation experience recurrent instability episodes [5,6], which predisposes the patellofemoral joint to further damage. Up to 73% of the patients undergoing surgical treatment exhibited cartilage damage of varying severity [7]. These injuries might have a significant impact on the patient’s life, such as physical activity modifications and decreased physical fitness [8]. The purpose of this review is to summarize the current knowledge on the pathophysiology, evaluation, and treatment of pediatric patellar instability. Summarize the current knowledge on the pathophysiology, evaluation, and treatment of pediatric patellar instability
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