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Radiographic Evaluation of Pediatric Patients with Patellofemoral Instability

  • Pediatric Orthopedics (I Swarup, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to highlight the radiographic assessments of utility in the evaluation of a pediatric patient with patellofemoral instability to facilitate a thorough work-up. Understanding of these measures is useful in understanding evolving research in this field, providing accurate patient risk assessment, and appropriately directing surgical decision-making.

Recent Findings

Recent literature has broadened the radiographic characterization of the pediatric patellar instability and its anatomic risk factors. Knee MRI can inform the assessment of skeletal maturity and novel axial alignment measurements may enhance our identification of patients at increased risk of recurrent instability. Additional improvements have been made in the objective measurement and classification of trochlear dysplasia.

Summary

Knee MRI-based skeletal age assessments may obviate the need for hand bone age assessments in growing children with patellofemoral instability. Novel objective measures exist in the evaluation of pediatric patellar instability both in the assessment of axial alignment and trochlear dysplasia. Future work should focus on how these measures can aid in guiding surgical decision-making.

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Authors and Affiliations

  1. University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA

    Kevin J. Orellana

  2. Department of Orthopaedics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Morgan G. Batley, J. Todd R. Lawrence & Brendan A. Williams

  3. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    J. Todd R. Lawrence, Jie C. Nguyen & Brendan A. Williams

  4. Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Jie C. Nguyen

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This manuscript has not been published previously. All authors made significant contributions to multiple aspects of the study as described in the ICMJE authorship criteria recommendations, detailed here:

• Kevin J. Orellana: substantial contributions to data acquisition, data interpretation, manuscript drafting, critical revision, and final approval of the version to be published.

• Morgan G. Batley: substantial contributions to data acquisition, data interpretation, manuscript drafting, critical revision, and final approval of the version to be published.

• J. Todd R. Lawrence: substantial contributions to concept and design, data interpretation, critical revision, and final approval of the version to be published.

• Jie C. Nguyen: substantial contributions to concept and design, data interpretation, critical revision, and final approval of the version to be published.

• Brendan A. Williams: substantial contributions to conception and design, data acquisition, data interpretation, manuscript drafting, critical revision, and final approval of the version to be published.

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Kevin J. Orellana, Morgan G. Batley, Jie C. Nguyen, and Brendan A. Williams declare that they have no conflict of interest. J. Todd R. Lawrence is a board or committee member of the American Academy of Pediatrics and has received IP royalties from Sawbones/Pacific Research Laboratories.

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Orellana, K.J., Batley, M.G., Lawrence, J.T.R. et al. Radiographic Evaluation of Pediatric Patients with Patellofemoral Instability. Curr Rev Musculoskelet Med 15, 411–426 (2022). https://doi.org/10.1007/s12178-022-09780-5

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