Clinical Review

Special Considerations for Pediatric Patellar Instability

Publish date: March 27, 2018

Sean Keyes, DO

Meghan Price, BS

Daniel W. Green, MD

Shital N. Parikh, MD

TAKE-HOME POINTS

Patellofemoral joint stability is dependent on a complex interplay of musculotendinous units, ligaments, and the osteocartilaginous morphology of the patellofemoral joint.
Varied patterns of patellar instability in the pediatric population should be recognized. Habitual dislocation in flexion and permanent dislocation are the more severe types.
Assessment of major risk factors and, if required, their correction would influence management decisions and would have prognostic value related to outcomes.
Physeal-sparing MPFL reconstruction can suffice for most children and adolescents with recurrent patellar dislocation.
Distal stabilization techniques and quadricepsplasty are an important part of surgical armamentarium, especially for the more complex patellar instability patterns.

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