Anatomic Reconstruction of the Medial Patellofemoral Ligament in Children and Adolescents With Open Growth Plates

@article{Nelitz2013AnatomicRO,
  title={Anatomic Reconstruction of the Medial Patellofemoral Ligament in Children and Adolescents With Open Growth Plates},
  author={Manfred Nelitz and Jens Dreyhaupt and Heiko Reichel and Julia V. Woelfle and Sabine Lippacher},
  journal={The American Journal of Sports Medicine},
  year={2013},
  volume={41},
  pages={58 - 63}
}
Background: Recurrent lateral patellar dislocation is a common knee injury in the skeletally immature adolescent. Because of the open physis, operative therapy in children is challenging. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the medial patellofemoral ligament (MPFL) in children that respects the distal femoral physis. Hypothesis: Anatomic reconstruction of the MPFL in children that maintains the distal femoral physis will prevent… 
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Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents using a pedicled quadriceps tendon graft shows favourable results at a minimum of 2-year follow-up
TLDR
The described technique for MPFL reconstruction with a pedicled superficial quadriceps tendon is a safe and effective technique with good clinical results and allows patients to return to sports without redislocation of the patella.
Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents using a pedicled quadriceps tendon graft.
Variation in the Medial Patellofemoral Ligament Origin in the Skeletally Immature Knee: An Anatomic Study
TLDR
Surgical reconstruction of the medial patellofemoral ligament is a common treatment to restore patellar stability and this study demonstrated that the MPFL origin was more proximal and anterior with respect to the physis in the older age group.
Axial patellar engagement index and patellar tilt after medial patello-femoral ligament reconstruction in children and adolescents.
Clinical outcome after reconstruction of the medial patellofemoral ligament in paediatric patients with recurrent patella instability
TLDR
Clinical outcome in a consecutive single clinic series of children treated with paediatric MPFL reconstruction using a soft tissue femoral fixation technique was presented, and patella stability after MPFL reconstructed using femoral soft tissue graft fixation in paediatric patients was inferior to MPFL Reconstruction using bony Femoral fixation in adult patients.
Medial patellofemoral ligament (MPFL) reconstruction technique using an epiphyseal femoral socket with fluoroscopic guidance helps avoid physeal injury in skeletally immature patients
TLDR
These results demonstrate that with fluoroscopic guidance, placing the femoral socket distal to the distal femoral physis is an effective method for avoiding physeal injury and subsequent growth disturbances in children with patellar instability.
Acquired femoral flexion deformity due to physeal injury during medial patellofemoral ligament reconstruction.
Safe Drilling Paths in the Distal Femoral Epiphysis for Pediatric Medial Patellofemoral Ligament Reconstruction
TLDR
Because of the anatomy of the distal femoral physis, drilling into the epiphysis from the MPFL attachment site at improper trajectories risks damage to sensitive structures, so more attention should be paid to the radiographic anteroposterior view intraoperatively.
Midterm Results After Isolated Medial Patellofemoral Ligament Reconstruction as First-Line Surgical Treatment in Skeletally Immature Patients Irrespective of Patellar Height and Trochlear Dysplasia
TLDR
Isolated medial patellofemoral ligament reconstruction as first-line surgical treatment in skeletally immature patients yields excellent midterm results, irrespective of patellar height and trochlear dysplasia.
Imaging assessment of patellar instability and its treatment in children and adolescents
TLDR
The purpose of this review is to illustrate the imaging findings of transient patellar dislocation in the acute setting, the normal imaging appearance after surgical intervention, and post-surgical complications.
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References

SHOWING 1-10 OF 41 REFERENCES
Zone of Injury of the Medial Patellofemoral Ligament After Acute Patellar Dislocation in Children and Adolescents
TLDR
The MRI finding that the anatomic insertion of theMPFL is distal to the physis in 93% of patients and that the MPFL is more likely to be injured at the patellar attachment has important implications in the surgical reconstruction of the MP FL in pediatric or adolescent patients.
Anatomical reconstruction of the medial patellofemoral ligament in children with open growth-plates
TLDR
A minimal invasive technique is presented for anatomical reconstruction of the medial patellofemoral ligament in children respecting the distal femoral physis in children with recurrent lateral patellar dislocation.
The Docking Technique for Medial Patellofemoral Ligament Reconstruction
TLDR
The docking technique for MPFL reconstruction is an effective surgical procedure for the treatment of patellar instability and patients who are treated with the docking technique will have improvements in knee symptoms and function.
Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children.
TLDR
It is concluded that this technique can be recommended for the treatment of habitual or recurrent patellar dislocation in children, although hypermobility and patella alta are not fully corrected.
Osteotomies in Patello-Femoral Instabilities
TLDR
The surgical treatment is aimed at restoring the congruence of the patellofemoral articulation and correcting extensor mechanism malalignment, to prevent recurrence of dislocation.
Medial Patellofemoral Ligament Repair for Recurrent Patellar Dislocation
TLDR
Isolated repair of the MPFL for recurrent patellar instability is associated with a relatively high failure rate, but remains a viable surgical option if surgical technique principles are followed.
The anatomy and reconstruction of the medial patellofemoral ligament.
Treatment of Lateral Patella Dislocation in the Skeletally Immature Athlete
TLDR
An algorithm for treatment of LPD in the skeletally immature patient is presented with specific discussion of surgical technique options.
Radiographic Landmarks for Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction
TLDR
A reproducible anatomical and radiographic point, 1 mm anterior to the anterior cortex extension line, 2.5 mm distal to the posterior origin of the medial femoral condyle, and proximal to the level of the posterior point of the Blumensaat line on a lateral radiograph with both posterior condyles projected in the same plane, shows the mean femoral medial patellofemoral ligament center.
Analysis of failed surgery for patellar instability in children with open growth plates
TLDR
Trochlear dysplasia seems to be a major risk factor for failure of operative stabilization of recurrent patellofemoral instability in children and adolescents after unsuccessful operative stabilization in childhood and adolescence.
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