Kevin J Orellana1, Morgan G Batley2, J Todd R Lawrence2,3, Jie C Nguyen3,4, Brendan A Williams5,6. 1. University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA. 2. Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 3. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 4. Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 5. Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. williamsba@chop.edu. 6. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. williamsba@chop.edu.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to highlight the radiographic assessments of utility in the evaluation of a pediatric patient with patellofemoral instability to facilitate a thorough work-up. Understanding of these measures is useful in understanding evolving research in this field, providing accurate patient risk assessment, and appropriately directing surgical decision-making. RECENT FINDINGS: Recent literature has broadened the radiographic characterization of the pediatric patellar instability and its anatomic risk factors. Knee MRI can inform the assessment of skeletal maturity and novel axial alignment measurements may enhance our identification of patients at increased risk of recurrent instability. Additional improvements have been made in the objective measurement and classification of trochlear dysplasia. Knee MRI-based skeletal age assessments may obviate the need for hand bone age assessments in growing children with patellofemoral instability. Novel objective measures exist in the evaluation of pediatric patellar instability both in the assessment of axial alignment and trochlear dysplasia. Future work should focus on how these measures can aid in guiding surgical decision-making.
PURPOSE OF REVIEW: The purpose of this review is to highlight the radiographic assessments of utility in the evaluation of a pediatric patient with patellofemoral instability to facilitate a thorough work-up. Understanding of these measures is useful in understanding evolving research in this field, providing accurate patient risk assessment, and appropriately directing surgical decision-making. RECENT FINDINGS: Recent literature has broadened the radiographic characterization of the pediatric patellar instability and its anatomic risk factors. Knee MRI can inform the assessment of skeletal maturity and novel axial alignment measurements may enhance our identification of patients at increased risk of recurrent instability. Additional improvements have been made in the objective measurement and classification of trochlear dysplasia. Knee MRI-based skeletal age assessments may obviate the need for hand bone age assessments in growing children with patellofemoral instability. Novel objective measures exist in the evaluation of pediatric patellar instability both in the assessment of axial alignment and trochlear dysplasia. Future work should focus on how these measures can aid in guiding surgical decision-making.
Authors: Philip B Schoettle; Marco Zanetti; Burkart Seifert; Christian W A Pfirrmann; Sandro F Fucentese; Jose Romero Journal: Knee Date: 2005-07-14 Impact factor: 2.199
Authors: Carlo Camathias; Bernhard Maria Speth; Erich Rutz; Thomas Schlemmer; Kata Papp; Patrick Vavken; Kathrin Studer Journal: JBJS Essent Surg Tech Date: 2018-04-11