Background: The current treatment for habitual dislocation and nonoperative treatment failure is surgical therapy. Therefore, this study describes chronic patella dislocation's comprehensive evaluation and management in an adolescent woman with cerebral palsy (CP).Case Report: A 15 years old female patient has suffered knee pain for almost three years. Furthermore, the physical examination revealed positive adam's forward bending test and left knee cap dislocation with positive patellar J-sign at 90°. Radiologic examination of the vertebrae and left knee shows scoliosis left thoracolumbar curved with 43 cobb angle and patellar shift. The patient was then diagnosed with habitual patellar dislocation, spastic diplegia type of CP, and neuromuscular scoliosis, consulted to the pediatric department, and then planned for medial patellofemoral ligament (MPFL) reconstruction. During the surgical examination, we discovered the MPFL Agenesis. Finally, lateral release and plication of the medial retinaculum were selected for surgery and planned to receive a Boston brace for scoliosis. After six weeks of follow up, the patient shows a reduction in pain.Discussion: Lateral release and MPFL reconstruction for patellar stabilization generate better results. However, in this case, the absence of the medial patellar facet and the medial femoral condyle enhances Lateral release and plication of the medial retinaculum more preferable to fixate the left patella and improve functional limitation.Conclusion: Comprehensive and immediate treatment for a patient with habitual patella dislocation and other predisposition diseases increases the chances of success.

Background: Mesenchymal stem / stromal cell therapy (MSCs) is now an effective therapeutic modality for treating various diseases. In its application, stem cells require signaling molecules which can be growth factors, cytokines, or chemokines. Signal molecules work orderly and are greatly influenced by the physiological environment. Stem cell culture techniques with hypoxic conditions can produce growth factors close to physiological conditions in fractures. This study aims to perceive the different expressions of some growth factors in cultured normoxic and hypoxic BMSC.Methods: This study is an in vitro laboratory experimental study of normoxic Bone Marrow Stem Cells (BMSCs) and Hypoxic Bone Marrow Stem Cells (BMSCs) cultures. The BMSCs experimental unit was taken from rabbits and then propagated in vitro and cultured under two conditions, normoxia and hypoxia. Then the number of VEGF, TGF-β, BMP-2 growth fractures was observed using ELISA.Results: VEGF, TGF-β, and BMP-2 expressions showed significant differences between the normoxia and hypoxia groups. VEGF, TGF-β, and BMP-2 expression were higher in the hypoxia group compared with the normoxia group (p < 0.05).Conclusion: The expression analysis of TGFβ-1, VEGF, and BMP-2 growth factors in cultured BMSC were statistically significant between normoxic and hypoxic conditions. TGFβ-1, VEGF, and BMP-2 expressions increase in hypoxic conditions.