title: Anatomic physeal-sparing technique for medial patellofemoral ligament reconstruction in skeletally immature patients with ligamentous laxity.
abstract: OBJECTIVE
  To evaluate the clinical outcome of this modified physeal-sparing technique for MPFL reconstruction in skeletally immature patients with ligament laxity.
  
  
  METHODS
  This study was conducted on 16 patients (11 females and 5 males) with an average age of 11.5 years (8-15). They all had recurrent patellar dislocation with generalized ligament laxity (mean Beighton's score of 7) and no patellar tilt on X-ray. We modified the Frank Noyes' non-anatomic technique for MPFL reconstruction to become anatomic without hardware fixation for the graft.
  
  
  RESULTS
  The mean follow-up period was 29.25 months (SD 4.3) ranged from 24 to 34 months. Preoperative Kujala score had ranged from 49 to 61 points (mean of 56, SD 4.72), improved to be ranged from 90 to 99 points (mean 94, SD 2.73), which is considered highly significant (p value < 0.005). Till the latest follow-up, there were no definite re-dislocation episodes in any of our patients.
  
  
  CONCLUSIONS
  The described technique allows reconstruction of the MPFL in skeletally immature patients with ligament laxity avoiding any potential risks of growth disturbances or chondral damage as compared to other techniques. The modification of two-point femoral fixation allows both a more anatomic and more secure form of reconstruction and is cost-effective without the need for hardware.
authors.affiliation: Department of Orthopedic Surgery, Ain Shams University Hospitals, 11 Latif Mansour St., P.O. box: 11341, Heliopolis, Cairo, Egypt, magedmsamy2000@yahoo.com.
authors.forename: Maged Mohamed
authors.initials: MM
authors.lastname: Abouelsoud
authors.forename: Amr
authors.initials: A
authors.lastname: Abdelhady
authors.forename: Ossma
authors.initials: O
authors.lastname: Elshazly
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery; D031222:Patellar Dislocation / Q000000981:diagnostic imaging / Q000601:surgery; D057071:Patellofemoral Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods