J Korean Orthop Assoc.  2018 Jun;53(3):201-209. 10.4055/jkoa.2018.53.3.201.

Surgical Treatment of Patellar Instability in Children and Adolescents

• Lee JW
• Lee Y
• Park KB

• KMID: 2429167
• DOI: http://doi.org/10.4055/jkoa.2018.53.3.201

Abstract

Patellar instability in children and adolescents is caused by abnormalities of various knee structures. Instability of the patellofemoral joint can manifest as an acute dislocation, recurrent dislocation, habitual dislocation, and congenital dislocation. Patellar instability is associated with abnormalities in the anatomical structures around the knee, and a comprehensive analysis of the cause should be undertaken. Surgery can be performed to reconstruct any abnormal musculo-skeletal alignment. Considerable progress has been made in the treatment of patellar instability in recent years, and surgical methods include lateral release, soft tissue realignment procedure, transfer of the autologous tendon, trochleaplasty, and reconstruction of the medial patellofemoral ligament.

Keyword

patella; joint instability; joint dislocation; child; adolescent

MeSH Terms

Adolescent*
Child*
Dislocations
Humans
Joint Instability
Knee
Ligaments
Patella
Patellofemoral Joint
Tendons

Figure

• 

  Figure 1 (A) Lateral dislocation on Merchant view. (B) Trochlear hypoplasia.

• 

  Figure 2 (A) Subluxation of the patella and aplasia of the trochlear groove on Merchant view. (B) Supratrochlear bump and patella alta.

• 

  Figure 3 (A) Lateral dislocation before the procedure. (B) Trochlear hypoplasia was observed after lateral release. (C) Completion of ‘Four-in-one’ procedure.

• 

  Figure 4 Reconstruction of the medial patellofemoral ligament. (A) Use of quadriceps tendon. (B) Kirshiner wire at the femoral insertion site. (C) Preoperative merchant view. (D) Postoperative 3 months merchant view.

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