Objective:

To identify recurrent patellofemoral instability rates after MPFL reconstruction and other soft tissue realignment techniques in skeletally immature patients, specifically those with open physes or aged ≤ 12 years (girls) or ≤ 14 years (boys).

Key Findings:

• Recurrent instability rates after MPFL reconstruction are comparable to those after other soft tissue realignment techniques, though variability exists.
• The overall incidence of patellar dislocation is higher in adolescents aged 14 to 18 years.
• The pathomechanism of patellofemoral instability is multifactorial, involving anatomical and ligamentous factors.

Interpretation:

The findings suggest that while MPFL reconstruction is a viable option, its effectiveness in preventing recurrent instability is similar to other techniques, necessitating careful consideration in surgical decision-making.

Limitations:

• Variability in success rates among different surgical techniques, which may affect generalizability.
• Limited data on skeletally immature patients due to a focus on adults in existing literature, potentially skewing results.
• Potential biases in the included studies as assessed by the ROBINS-I tool, which may influence the reliability of findings.

Conclusion:

The study provides evidence that informs clinicians about the risks of recurrent instability after various surgical interventions for patellofemoral instability in skeletally immature patients, highlighting the need for careful surgical decision-making.