Patellar Dislocation in Skeletally Immature Athletes

Shea, Kevin G.; Nilsson, Kurt J.; Belzer, Jennifer

doi:10.1053/j.otsm.2006.08.001

Cited by 14 publications

(11 citation statements)

References 103 publications

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“…A patellar dislocation is a common injury sustained by young, active patients, with nearly 70% of dislocations occurring during sports activities. 20,43,44,50,55,56,63 The risk of redislocations after treatment and rehabilitation has been reported from 0% to 71% in young athletes. 43 Recently, surgical reconstruction of the MPFL has gained popularity in the treatment of patellar dislocations, particularly in the setting of recurrent dislocations and/or chronic instability.…”

Section: Discussionmentioning

confidence: 99%

“…39,43,44,55,56,63 The incidence of dislocations among pediatric patients is estimated at 43 per 100,000, with a peak incidence for patients of all ages occurring at age 15 years. 44,55 The clinical presentation includes frequent “giving way” episodes, swelling, restricted knee range of motion (ROM), and limited functional activities. 2,63 These injuries are associated with significant morbidity such as recurrent instability and patellofemoral osteoarthritis and can lead to physical activity modifications and declines in physical capacity.…”

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confidence: 99%

“…A patellar dislocation is one of the most common acute knee disorders in children and adolescents. 39,43,44,55,56,63 The incidence of dislocations among pediatric patients is estimated at 43 per 100,000, with a peak incidence for patients of all ages occurring at age 15 years. 44,55 The clinical presentation includes frequent “giving way” episodes, swelling, restricted knee range of motion (ROM), and limited functional activities.…”

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confidence: 99%

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Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations

et al. 2016

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Background A patellar dislocation is a common knee injury in the young, athletic patient population. Recent trends indicate that the use of long-term nonoperative treatment is decreasing, and surgical intervention is more commonly recommended for those patients who fail initial nonoperative management with recurrent patellar dislocations. Medial patellofemoral ligament (MPFL) reconstruction has become increasingly utilized in this regard. Purpose To evaluate outcomes, particularly return to sports and its relationship to postoperative instability, of isolated MPFL reconstruction for the treatment of recurrent patellar dislocations. Study Design Systematic review and meta-analysis. Methods A review of the current literature was performed using the terms “medial patellofemoral ligament reconstruction” and “MPFL reconstruction” in the electronic search engines PubMed and EBSCOhost (CINAHL, MEDLINE, SPORTDiscus) on July 29, 2015, yielding 1113 abstracts for review. At the conclusion of the search, 14 articles met the inclusion criteria and were included in this review of the literature. Means were calculated for population size, age, follow-up time, and postoperative Tegner scores. Pooled estimates were calculated for postoperative Kujala scores, return to play, total risk of postoperative instability, risk of positive apprehension sign, and risk of reoperation. Results The mean patient age associated with MPFL reconstruction was 24.4 years, with a mean postoperative Tegner score of 5.7. The pooled estimated mean postoperative Kujala score was 85.8 (95% CI, 81.6–90.0), with 84.1% (95% CI, 71.1%–97.1%) of patients returning to sports after surgery. The pooled total risk of recurrent instability after surgery was 1.2% (95% CI, 0.3%–2.1%), with a positive apprehension sign risk of 3.6% (95% CI, 0%–7.2%) and a reoperation risk of 3.1% (95% CI, 1.1%–5.0%). Conclusion A high percentage of young patients return to sports after isolated MPFL reconstruction for chronic patellar instability, with short-term results demonstrating a low incidence of recurrent instability, postoperative apprehension, and reoperations.

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Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations

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“…12 Osteochondral injuries are common with lateral dislocation of the patella and rates are reported at 40 to 50%. 5,7,14 These fragments are secondary to shearing forces during the dislocation event and typically originate from the medial patella facet or the lateral femoral condyle. The severity of these injuries can determine surgical versus nonsurgical management.…”

Section: Evaluation Of First-time Patellofemoral Dislocationmentioning

confidence: 99%

“…13 However, the association of these anatomic factors and their effect on patellar instability has not been clearly defined and controversy still exits regarding the specific role of each of these anatomic variants. 14…”

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Patellofemoral Instability in Active Adolescents

Ries

Bollier

2015

J Knee Surg

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Patellofemoral instability is a common problem in the adolescent population. Patellar stability depends on a dynamic interplay between bony and soft tissue restraints. Several pathoanatomical factors increase the likelihood of patellar instability: patella alta, trochlear dysplasia, malalignment, and deficient proximal medial restraints. Treatment for first-time patella dislocations is typically nonoperative and includes bracing, early range of motion, and physical therapy. The only absolute indication for early surgery is a large osteochondral fragment that can be fixed. Surgical stabilization is indicated for chronic patellar instability and includes both proximal and distal realignment options. Medial patellofemoral ligament reconstruction is the treatment of choice in most adolescent patients with patella instability. Distal bony realignment procedures are reserved for skeletally mature adolescents.

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Patellar Instability in Children and Adolescents

Kircher

Krauspe

2014

European Surgical Orthopaedics and Traumatology

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Patellar Dislocation in Skeletally Immature Athletes

Cited by 14 publications

References 103 publications

Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations

Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations

Patellofemoral Instability in Active Adolescents

Patellar Instability in Children and Adolescents

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