LOS ANGELES--(BUSINESS WIRE)--Children experiencing patellar instability will see positive results after reconstruction surgery to correct the medial patellofemoral ligament (MPFL), according to a study released this week by orthopedic surgeon Jennifer Weiss, MD, of Childrens Hospital Los Angeles, when presenting at the American Academy of Pediatrics 2010 National Conference in San Francisco.
“Previously, reconstruction of the MPFL has been studied broadly in adults with patellar instability, but this technique has been seen as controversial for use in children,” said Dr. Weiss. "In the past, children with patellar dislocations did not have many good options from which to choose.”
Dr. Weiss said a review was conducted on all MPFL reconstructions performed by a single surgeon at a pediatric hospital. Of the 27 patients that were studied, there were 29 knee operations conducted during a three-year period. The average age of the patients was 14.4 years (range, 7 to 18 years). There were 13 female patients (48 percent) and 14 male patients (52 percent). The surgeon operated on 12 left knees (41 percent) and 13 right knees (45 percent); two patients (7 percent) underwent bilateral procedures. Patellar fixation was achieved via biotenodesis screw, and femoral fixation was achieved at the adductor tubercle via interference screw. Arthroscopy was used to evaluate the joint, as well as to perform a lateral release, if indicated for lateral patellar tilt. A chart review was performed to assess post-operative range of motion, complications and incidence of redislocation in all patients. Functional outcome was completed in eight patients using the International Knee Documentation Committee, the Lysholm Knee Score, and Tegner Activity Score.
“When we followed up with patients seven months later, we found reconstruction of the MPFL in children using this technique demonstrated good short term results,” Dr. Weiss said. “Children with injuries that mimic sports injures in adults have done extremely well. Early complication and redislocation rates were low, while functional outcome was excellent and patient and family satisfaction was high.”
Dr. Weiss noted that patients who failed with this surgery all had other medical problems, or "comorbidities." One patient had cerebral palsy, one had a congenitally short femur, and one had down's syndrome.
“Patients with comorbidities require more involved surgery, and I have transitioned these patients into in my practice since seeing these results,” Dr. Weiss said. “In these patients, their muscles are different. Their movements are typically overactive in some places and underactive in others, so their coordination and balance is much different. Whatever we do as part of their surgery, we need to understand that their muscles, joints and ligaments are stressed in a different, more demanding way."
About Childrens Hospital Los Angeles: Founded in 1901, Childrens Hospital Los Angeles is one of the nation’s leading children’s hospitals and is acknowledged worldwide for its leadership in pediatric and adolescent health. Childrens Hospital Los Angeles is one of only seven children’s hospitals in the nation – and the only children’s hospital on the West Coast – ranked for two consecutive years in all 10 pediatric specialties in the U.S. News & World Report rankings and named to the magazine’s “Honor Roll” of children’s hospitals. The Saban Research Institute at Childrens Hospital Los Angeles is among the largest and most productive pediatric research facilities in the United States, with 100 investigators at work on 186 laboratory studies, clinical trials and community-based research and health services. The Saban Research Institute is ranked eighth in National Institutes of Health funding among children’s hospitals in the United States. Childrens Hospital Los Angeles is a premier teaching hospital and has been affiliated with the Keck School of Medicine of the University of Southern California since 1932.
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