Patellofemoral Instability in the Skeletally Immature Patient: A Review and Technical Description of Medial Patellofemoral Ligament Reconstruction in Patients with Open Physes
Dr. Ellis is an Assistant Professor in the Orthopaedic Department of the University of Texas Southwestern and Orthopaedic Surgeon at Texas Scottish Rite Hospital for Children, Dallas, Texas. Mr. Dennis is a research assistant at the University of Texas Southwestern, Dallas, Texas. Dr. Wilson is an Associate Professor in the Orthopaedic Department of the University of Texas Southwestern and Orthopaedic Surgeon at Texas Scottish Rite Hospital for Children, Dallas, Texas.
Authors’ Disclosure Statement: Dr. Ellis reports receiving funding from Smith and Nephew (HE) and Dr. Wilson, from Elsevier.
Address correspondence to: Henry B. Ellis, Jr, University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, Texas (tel, 469-515-7121; fax, 469-515-7101; email, henry.ellis@tsrh.org)
Henry B. Ellis, Jr, MD Garrett Dennis, BS Philip L. Wilson, MD . Patellofemoral Instability in the Skeletally Immature Patient: A Review and Technical Description of Medial Patellofemoral Ligament Reconstruction in Patients with Open Physes. Am J Orthop.
December 18, 2018
TAKE-HOME POINTS
Patellofemoral instability is common in the skeletally immature age group.
Many treatment options exist for patellofemoral instability; however, a medial patellofemoral ligament (MPFL) reconstruction is an option in a skeletally immature patient.
Allograft or autografts may be utilized for the MPFL reconstruction.
Three options exist to confirm location of the MPFL origin on the patella, but only one drill tunnel is recommended in pediatrics.
During identification of MPFL origin, special views in the coronal plane should be considered to avoid injury or damage to the growth plate.
References
ABSTRACT
Patellofemoral instability commonly occurs in the young patient, and, often, skeletal immaturity may be a risk factor for possible recurrence. Treatment considerations, including operative and nonoperative management, are based on anatomic factors. A medial patellofemoral ligament (MPFL) reconstruction is a treatment option for a skeletally immature patient with recurrent instability or for patients with a high risk of patellofemoral instability recurrence. A physeal-sparing MPFL reconstruction technique that considers the origin of the MPFL to be distal to the distal femoral physis may be employed.
