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Patellar Instability in Children and Adolescents

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European Surgical Orthopaedics and Traumatology

Abstract

Patello-femoral disorders are a common problem in Orthopaedic practice especially acute patellar dislocation with the peak incidence at the age of thirteen to fifteen years. In almost all cases the direction of patellar displacement is to the lateral side with a high risk of recurrence. Usually there is a combination of several risk factors such as valgus deformation, hyperlaxity and weakness of the dynamic stabilizers. The diagnosis and treatment decision is based on a thorough clinical examination and further diagnostic imaging (radiographs, MRI, CT). Operative surgery is indicated for recurrent instability and severe injury to the stabilizing anatomical structures such as the MPFL and cartilage. The preferred surgical technique is anatomical reconstruction of the injured structures with special attention to the growth-plates at the knee to avoid axial deformation and growth disturbance. Successful intervention and early rehabilitation are the basis for prevention of recurrence, joint preservation and avoidance of patello-femoral osteoarthritis in the long-term.

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Authors and Affiliations

  1. Department of Orthopaedics, Medical Faculty, Heinrich–Heine–University, Moorenstrasse 5, 40255, Düsseldorf, Germany

    Jörn Kircher

  2. Department of Orthopedic Surgery, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Rüdiger Krauspe

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  1. Jörn Kircher
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  2. Rüdiger Krauspe
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Correspondence to Jörn Kircher .

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  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

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Kircher, J., Krauspe, R. (2014). Patellar Instability in Children and Adolescents. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_204

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