Differenzierte Behandlung der Patellaluxation im Adoleszentenalter

Abstract

Background: Dislocation of the patella is relatively common in adolescence with an incidence of 29–43 per 100,000. Therapy: The aim of treatment is to avoid recurrent dislocation of the patella and its sequelae (e.g. chronic instability, reduced level of activity and patellar osteoarthritis). Treatment must be adjusted to the anatomical cause of instability. Principal treatment options are conservative treatment (immobilization, vastus medialis muscle and gluteal muscle exercises) and operative treatment, such as repair of the medial patellar attachment by suturing and medial patellofemoral ligament (MPFL) repair, transposition of the tibial tuberosity in cases of pathological tibial tubersosity-trochlear groove (TTTG) distance and trochleaplasty in cases of extreme dysplasia (seldom). Lateral release has to be avoided. Prognosis: Provided adequate therapy is carried out, the prognosis of patella dislocation in adolescents is good.