Abstract
#Patellofemoralinstability (PFI) is a debilitating injury for the
patient and a challenging problem for the surgeon. The incidence
of PFI ranges from 5.8 to 77.8 per 100,000 and recurrence rates of
nonoperatively treated dislocations range from 15% to 50% [1]. In
children and adolescents, the recent studies showed the incident
of PFI of 43 per 100,000 [2] and the recurrent rates between 30%
and 38% [2,3]. The medial patella #femoralligament (MPFL) is the
primary #soft-tissue restraint to lateral patellar translation [4]. The
MPFL has a “sail-like” appearance with two functional portions:
inferior straight bundle and superior oblique bundle. The MPFL
originates from the medial femoral #condoyle just proximal to the
femoral attachment of the medial collateral ligament and distal
to the adductor tubercle. It inserts on the super medial border
of the #patella. In children and adolescents with open phases, the
femoral insertion is located slightly distal (4 to 5mm) to the medial
femoral physics [5]. During 0 to 30 degrees of knee flexion, the
MPFL contributes more than 60% of the medial stability of the
patella and isolated insufficiency leads to increased lateralization
or dislocation [6].
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