ArticleJournal of the Pediatric Orthopaedic Society of North America2026
National Trends in the Surgical Management of Pediatric Patellofemoral Instability: A Retrospective Analysis From 2010 to 2022.
Article in Journal of the Pediatric Orthopaedic Society of North America, 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: Patellofemoral instability (PFI) is a significant cause of knee dysfunction in children and adolescents, sometimes requiring surgery when conservative treatment fails. The literature suggests that surgical approaches for PFI in this population have evolved in recent decades. This study aimed to do the following: (1) evaluate recent nationwide temporal trends in the timing and type of surgical interventions to treat PFI and (2) compare complication rates among interventions in this population. Methods: A retrospective analysis of a large national administrative claims database (PearlDiver) identified pediatric patients ( Results: Among 365,031 pediatric patients diagnosed with PFI, 5,204 underwent surgical intervention and 4,635 had Conclusions: MPFLR, with or without TTO, has become the leading surgical approach for treating PFI in pediatric patients. Its increasing utilization over the past decade reflects growing acceptance as a safe and effective option, with low rates of serious complications requiring return to the operating room observed across all procedures. These findings offer valuable insights for risk-related counseling and surgical decision-making in this population. Key Concepts: (1)Utilization trends: MPFLR has increasingly replaced nonanatomical stabilization procedures and is now the predominant operative technique for pediatric patellofemoral instability.(2)Patient demographics: most patients undergoing surgery were adolescents, with a modest shift toward younger age in MPFLR cases reflecting wider adoption of physeal-sparing techniques.(3)Safety profile: one-year rates of infection, arthrofibrosis, and growth disturbance were low across all procedures, with no significant differences among MPFLR, MPFLR + TTO, and other stabilization approaches.(4)Clinical implications: MPFLR, with selective use of TTO in appropriately indicated patients, remains a reliable and safe option for pediatric patellofemoral instability and supports individualized, anatomy-guided care. Level of evidence: Level III.
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