A technique for treating patello-femoral instability in immature patients: the tibial tubercle periosteum transfer

Abstract

Patello-femoral problems are frequently encountered in knee clinic. The most important role of the patella is to increase the quadriceps efficiency, although this function could be altered in the patello-femoral instability. Active stability of the patello-femoral joint is provided by the surrounding muscles and ligaments, passive stability is provided by the bony and cartilage structures. Patellofemoral instability is defined, from Henry Dejour, as a disease without engagement the patella in the femoral trochlea during knee range of motion. Every time should be performed careful radiological preoperative investigations (radiographs and computed tomography) involving an expert musculoskeletal radiologist. Surgical procedures may be divided into those that address the soft tissues (muscles and ligaments), generally on the immature skeletal, and those that effect bony changes, generally on the mature skeletal; sometimes, it is necessary to combine soft-tissue and bony procedures. In this report, the authors describe a tibial tubercle periosteum transfer technique for patello-femoral instability in immature patients, which may potentially improve clinical results in very young symptomatic patients with patello-femoral instability.

Modified Roux-Goldthwait Procedure for Management of Patellar Dislocation in Skeletally Immature Patients with Down Syndrome

“…Many studies are focused on the management of patellar instability in children and it leads to the development of different surgical techniques involving only soft tissues such as distal realignment procedures (Roux-Goldthwait procedure,12 Galeazzi procedure,13 and patellar tendon transfer,14), proximal realignment procedures15 (VMO advancement), and medial patellar femoral ligament (MPFL) reconstruction 16…”

Der Tuberositas-Transfer im kindlichen Alter

“…Ein periostaler Transfer der Tuberositas wurde 2010 beschrieben 46 . Auch bei der im Folgenden beschriebenen modifizierten Technik werden eine kontrollierte Medialisierung und/oder eine Distalisierung ermöglicht, wie es der Tuberositas-Transfer beim Erwachsenen leisten kann 60 .…”