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Instability in the Skeletally Immature Patient

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Patellofemoral Pain and Instability

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Abstract

Skeletally immature patients are at higher risk for acute traumatic patellar dislocation compared to older patients. Evidence suggests that a significant percentage of skeletally immature patients who sustain a patellar dislocation will go on to develop recurrent patellar instability. Management of patellofemoral instability in the skeletally immature patient has a unique set of challenges, both non-operatively with compliance, perception, and expectation and operatively with important and technically challenging physeal considerations. Surgical treatment has shifted away from non-anatomic extensor mechanism realignments to physeal-sparing anatomic reconstruction of the medial patellofemoral ligament (MPFL). In addition, implant-mediated guided growth can be effective in correcting genu valgum angular deformities in growing patients with associated recurrent patellar dislocations. Proper patient selection and patient-specific surgical technique are essential to ensure best outcomes.

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Authors and Affiliations

  1. Columbia University Medical Center, Department of Orthopedic Surgery, New York, NY, USA

    Lauren H. Redler & Christopher S. Ahmad

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  1. Lauren H. Redler
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Editors and Affiliations

  1. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

    Beth E. Shubin Stein

  2. Hospital for Special Surgery, New York, NY, USA

    Sabrina M. Strickland

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Redler, L.H., Ahmad, C.S. (2019). Instability in the Skeletally Immature Patient. In: Shubin Stein, B., Strickland, S. (eds) Patellofemoral Pain and Instability. Springer, Cham. https://doi.org/10.1007/978-3-319-97640-2_6

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