Patellofemoral instability in skeletally immature athletes.

Acute patellofemoral dislocation is the most common acute knee disorder in children and adolescents. The predisposing factors for acute patellar dislocation are multifactorial. Unless associated with substantial articular cartilage damage, nonsurgical management is typically used to treat a first-time acute patellofemoral dislocation in a skeletally immature athlete. In the setting of recurrent instability, surgical reconstruction is usually recommended. Surgical treatment of patellofemoral instability in the skeletally immature athlete is evolving from nonanatomic extensor mechanism surgical procedures to anatomic restorative procedures based on reconstitution of the medial patellofemoral ligament. The current goal of surgery is to restore the normal anatomy of the patellofemoral joint. Proper patient selection and attention to technical details are important in achieving good outcomes.