Patellofemoral Instability in the Pediatric and Adolescent Population: From Causes to Treatments.
| Autor: | Ricciuti A; Connecticut Children's Sports Medicine, 399 Farmington Ave., Farmington, CT 06032, USA., Colosi K; Connecticut Children's Sports Medicine, 399 Farmington Ave., Farmington, CT 06032, USA., Fitzsimmons K; Connecticut Children's Sports Medicine, 399 Farmington Ave., Farmington, CT 06032, USA., Brown M; Connecticut Children's Sports Medicine, 399 Farmington Ave., Farmington, CT 06032, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Children (Basel, Switzerland) [Children (Basel)] 2024 Oct 18; Vol. 11 (10). Date of Electronic Publication: 2024 Oct 18. |
| DOI: | 10.3390/children11101261 |
| Abstrakt: | Background: Patella instability is one of the most common knee injuries in the adolescent patient. There are several pathoanatomic risk factors which should be assessed via several modalities, including X-rays, magnetic resonance imaging (MRI), or even CT scan. Objectives: We intend to review these risk factors along with the nonsurgical and surgical techniques used to prevent recurrent dislocations. Methods: We completed an extensive review of the recent literature concerning pediatric and adolescent patellar dislocation and subsequent treatment modalities. Results: We review in detail the risk factors such as patella alta, trochlear dysplasia, lateralization of the tibial tubercle or medialization of the trochlear groove (increased tibial tubercle to trochlear groove (TT-TG) distance), lower limb malalignment, excessive femoral anteversion and/or tibial torsion, and hyperlaxity. There are classification systems for dislocators, and a natural progression of instability that patients often proceed through. Only after a patient has continued to dislocate after bracing and physical therapy is surgical treatment considered. Surgical techniques vary, with the workhorse being the medial patellofemoral ligament (MPFL) reconstruction. However, there are a variety of other techniques which add onto this procedure to address other anatomic risk factors. These include the tibial tubercle osteotomy to address a large TT-TG distance or trochleoplasty to address the lack of a trochlear groove. Conclusions: Nonsurgical and surgical treatments for patella dislocators are tailored to the pathoanatomic risk factors in each patient. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|