Gerd Seitlinger1, Philipp Moroder2, Christian Fink3, Guido Wierer4. 1. Department of Orthopedic Surgery Oberndorf, Academic Teaching Hospital of the Paracelsus Medical University, Paracelsusstrasse 37, 5110 Oberndorf, Austria. Electronic address: g.seitlinger@gmx.de. 2. Center for Musculoskeletal Surgery, Campus Virchow, Charité -Universitaetsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: philipp.moroder@charite.de. 3. Gelenkpunkt - Center for Sports and Joint Surgery, Olympiastraße 39, 6020 Innsbruck, Austria; Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria. Electronic address: c.fink@gelenkpunkt.com. 4. Department of Orthopaedics and Traumatology, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria. Electronic address: wierer@gmail.com.
Abstract
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed. METHODS: This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient. The cause and treatment are discussed. RESULTS: Postoperative knee extension deficit and recurrent patellar instability were successfully treated with revision surgery including, distal femoral extension osteotomy, medialization of the tibial tuberosity, trochleoplasty and MPFL graft tensioning. CONCLUSION: This case highlights that care should be taken during femoral tunnel placement for anatomic graft fixation to avoid physeal injuries in skeletally immature patients.
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed. METHODS: This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient. The cause and treatment are discussed. RESULTS: Postoperative knee extension deficit and recurrent patellar instability were successfully treated with revision surgery including, distal femoral extension osteotomy, medialization of the tibial tuberosity, trochleoplasty and MPFL graft tensioning. CONCLUSION: This case highlights that care should be taken during femoral tunnel placement for anatomic graft fixation to avoid physeal injuries in skeletally immature patients.
Authors: Vicente Sanchis-Alfonso; Gerard Ginovart; Diego Alastruey-López; Erik Montesinos-Berry; Joan Carles Monllau; Angel Alberich-Bayarri; María Angeles Pérez Journal: J Clin Med Date: 2019-12-01 Impact factor: 4.241
Authors: Peter D Fabricant; Madison R Heath; Matthew Veerkamp; Simone Gruber; Daniel W Green; Sabrina M Strickland; Eric J Wall; Douglas N Mintz; Kathleen H Emery; Jacqueline M Brady; Henry B Ellis; Jack Farr; Benton E Heyworth; Jason L Koh; Dennis Kramer; Robert A Magnussen; Lauren H Redler; Seth L Sherman; Marc Tompkins; Philip L Wilson; Beth E Shubin Stein; Shital N Parikh Journal: Orthop J Sports Med Date: 2021-04-13