MPFL reconstruction: technique and results.

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Abstract

[Indexed for MEDLINE] 10. Curr Rev Musculoskelet Med. 2023 Jul;16(7):255-262. doi: 10.1007/s12178-023-09836-0. Epub 2023 Apr 18. Patellofemoral Instability in the Pediatric Population. Vivekanantha P(1), Cohen D(2), Peterson D(2), de Sa D(2). Author information: (1)Michael DeGroote School of Medicine, McMaster University, 1280 Main Street W, Hamilton, ON, Canada. prushoth.vivekanantha@medportal.ca. (2)Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada. PURPOSE OF REVIEW: This review focuses on the etiology, diagnosis, and management of patellar instability in pediatric patients. RECENT FINDINGS: Radiological outcomes such as tibial-tubercle to trochlear groove (TT-TG) distance used in diagnosis are subject to factors of influence such as femoral anteversion and knee flexion angle, and new measure such as tibial-tubercle to posterior cruciate ligament distance as well as TT-TG/trochlear width (TT-TG/TW) are under investigation. To prevent recurrent instability, surgical intervention for acute patellar dislocations may be advantageous compared to conservative management. Patellar instability is a common pathology found in pediatric cohorts. Diagnosis can be performed via a combination of history, physical examination maneuvers, and radiological risk factors such as patella alta, patellar tilt, trochlear dysplasia, and elevated TT-TG distances. Current literature advocates the usage of additional radiological measures to TT-TG such as TT-TG/TW, especially as TT-TG varies with age in younger patients. Recent literature potentially suggests the utilization of surgical procedures such as MPFL reconstruction or repair for acute dislocations in the hope of preventing recurrent instability. Special indications for pediatric patients include osteochondral fracture identification to help prevent patellofemoral osteoarthritis. A comprehensive workup and understanding of current literature can aid clinicians in aiming to prevent recurrent patellar dislocation in pediatric patients. © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. DOI: 10.1007/s12178-023-09836-0 PMCID: PMC10356699