Abstract:

Patellar instability in children represents abnormal movement of the patella outside its 
normal position within the femoral trochlea and may lead to subluxation or complete dislocation. 
The condition is most commonly observed in the 10–17-year age group and is more prevalent in 
girls. The aim of this paper is to present current data on the etiology, clinical presentation, 
diagnostic approach, and therapeutic strategies for patellar instability in pediatric patients. The 
main anatomical and traumatic risk factors are analyzed, along with imaging methods used for 
diagnosis—radiography and MRI—for the assessment of dislocation, osteochondral injuries, the 
condition of the medial patellofemoral ligament (MPFL), and predisposing anatomical features. 
Primary dislocation most often presents with acute pain, hemarthrosis of the knee joint, and visible 
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lateral dislocation, whereas recurrent instability is characterized by a sensation of “giving way,” 
pain, and a positive apprehension test. In cases of a first episode without osteochondral fragments, 
treatment is conservative, consisting of closed reduction, immobilization, and early rehabilitation. 
When osteochondral fragments or significant MPFL injury are present, surgical intervention is 
recommended. Recurrent instability requires repair or reconstruction of the MPFL, and in the 
presence of pronounced anatomical abnormalities, tibial tubercle osteotomy or trochleoplasty may 
be indicated. 
Successful management of patellar instability in children depends on an individualized approach 
tailored to the anatomical and functional characteristics of each patient. The appropriate choice 
between conservative and surgical treatment methods is crucial for preventing recurrent 
dislocations and optimizing clinical outcomes. 

Keywords: patella, dislocation, children, instability, habitual. 

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