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Beitragstitel High rates of lateral patellar redislocation and inconsistent subjective satisfaction in pediatric patients at 7-year follow-up
Beitragscode P48
  1. Tilman Kaim STS AG Thun Vortragender
  2. Nadine Kaiser Inselspital Bern Vortragender
  3. Thoralf Liebs Inselspital, Bern University Hospital, University of Bern
  4. Kai Ziebarth Clinic for Pediatric Surgery, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
Präsentationsform Poster
  • A07 - Spezialgebiet 1 | Kinder
Abstract Introduction
The optimal treatment of primary lateral patellar Dislocation (LPD) remains unclear. Reccurent dislocation is a common problem. Every redislocation leads to further cartilage damage. Different procedures are used in the pediatric population to lower recurrence rates but there is lack of success rates and subjective functional outcome in the long-term.

A retrospective case series involving 141 patients (98 girls, 43 boys) between 6 and 15 years at initial consultation that were treated at our institution from 01.2007 to 05.2018 due to LPDs with a minimum follow-up of 12 Month. A questionnaire focusing on recurrence of dislocation, secondary treatment, PROMs (Kujala AKPS, Pedi-IKDC) were answered with a follow-up rate of 80%. Exclusion criteria were syndromal and neurological disorders, malformations, no contact data and no command of German language.

The mean age at first consultation in our department was 12.3±2.2 (7-15 years). The mean follow-up was 7.0±3.1 years. 64 patients were treated operatively and 77 nonoperatively.
In the conservative cohort, 48 patients reported redislocations (62%) and 17 patients were operated externally after. Mean AKPS was 79±19 (21-100), mean IKDC was 77±19 (25-100).
7 patients were treated by medial temporary hemiepiphysiodesis of which 4 reported redislocations (57%) and one patient had a subsequent reoperation externally. Mean AKPS was 80±27 (27-100), mean IKDC was 73±31 (14-98).
20 patients received MPFL repair of which 8 reported redislocation (40%). 2 patients had subsequent reoperation. Mean AKPS was 88±11 (64-100), mean IKDC was 86±11 (54-96).
30 patients underwent the mod. Slocum procedure. 9 patients were operated on both knees. 3 patients underwent previously MPFL repair. 4 patients had concomitant trochleoplasty. 13 patients reported redislocation (43%). 10 patients had one or more subsequent reoperation. Mean AKPS was 77±16 (30-97), mean IKDC was 73±18 (26-96).
In 7 patients, we performed a MPFL reconstruction. 1 patient had previous MPFL repair externally. 1 patient reported redislocation (14%) and was reoperated. Mean AKPS was 74±17 (39-94), mean IKDC was 76±16 (46-93).

Redislocation rate after primary LPD was high. The MPFL reconstruction had the lowest recurrence rate. Subjective functional outcome scores are in all cohorts comparable, but with a wide variance in each cohort.