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Instability in the Skeletally Immature Patient

  • Lauren H. Redler
  • Christopher S. Ahmad
Chapter

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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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lauren H. Redler
    • 1
  • Christopher S. Ahmad
    • 1
  1. 1.Columbia University Medical Center, Department of Orthopedic SurgeryNew YorkUSA

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