Patellar Dislocations: A Literature Review of Adolescent and Pediatric Management Strategies
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Background: Acute patellar dislocations account for approximately 3% of all knee injuries and have high rate of recurrence, with up to 70% of patients who receive non-operative management experiencing a redislocation. While management options are varied, skeletal maturity must be considered when selecting between Medical Patellar Femoral Ligament (MPFL) repair or reconstruction, as issued related to growth arrest or leg length discrepancies in young patients may arise. To date, there remains a lack of consensus on preferred management strategy. Objective: To identify which method of patellar dislocation intervention (non-surgical, MPFL repair, or MPFL reconstruction) demonstrates the best clinical outcomes in skeletally immature adolescent and pediatric patients. Methods: A review was conducted spanning 2011-2021 using the following databases: SportDiscus, CINAHL, Pubmed, and Scopus Open Access. Key search terms included “patellar dislocation”, “mpfl”, and “adolescent”. All abstracts were screened against inclusion criteria. endorsed MPFL reconstruction. MPFL reconstruction demonstrated the lowest rate of redislocation and additional procedures, however inconsistency in reporting between studies relating to redislocation rates and subjective outcomes limits the ability to identify one optimal management style for this population. Conclusion: There remains no optimal management plan for skeletally immature adolescent and paediatric patients with patellar dislocation. Based on the heterogeneity of the results, it is evident that more research is required to determine the optimal approach for managing MPFL related injuries in skeletally immature patients.