ArticleOrthopaedic journal of sports medicine2026
Long-term Outcomes of Knee Brace Versus Operative Medial Patellofemoral Ligament Repair in Children With First-Time Traumatic Patellar Dislocation: A 10-Year Follow-up From Skeletal Immaturity to Adulthood.
Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Optimal management of first-time traumatic patellar dislocation (FTPD) in pediatric patients remains disputed. Nonoperative treatment avoids surgical risks and may be optimal for select patients, whereas operative medial patellofemoral ligament (MPFL) repair aims to prevent recurrent instability and reduce redislocation in the short term. Purpose: To compare the redislocation rate, subsequent surgical intervention, and subjective knee function between pediatric patients initially treated with a knee brace (KB) and those who underwent operative MPFL repair. Study Design: Cohort study; Level of evidence, 2. Methods: This 10-year follow-up study of 74 participants from a previously conducted randomized controlled trial included 46 patients (62%) available for reassessment (KB, n = 25; MPFL repair, n = 21). The primary outcomes, redislocation and subsequent knee surgery, were collected from questionnaires and medical records. Subjective knee function was measured using the Knee injury and Osteoarthritis Outcome Score for children (KOOS-Child), Kujala Anterior Knee Pain Scale, and Tegner Activity Score. Key anatomic risk factors were taken from magnetic resonance imaging scans at baseline. Group comparisons were performed at 10-year follow-up. Results: The KB group demonstrated a higher overall redislocation rate (80%) compared with the MPFL repair group (62%), although the difference was not statistically significant ( Conclusion: The long-term redislocation rate in FTPD for patients with MPFL repair was nearly as high as for patients treated nonoperatively. Subjective knee function was comparable between the 2 treatments. Given the high rate of recurring instability in children, the authors do not support routine MPFL repair for FTPD, nor do they support nonoperative treatment as the gold standard for every child. However, when nonoperative treatment is used, a structured follow-up should be mandatory.
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