Patellofemoral instability is a frequent cause of knee pathology affecting quality of life among the pediatric population. Here, we present a prospective cohort study which included patients who had undergone surgical management using the lateral release and medial imbrication approach (LRMI) or medial patellofemoral ligament reconstruction (MPFL-R). The object of this study was to assess the quality of life among children that have undergone surgical treatment for patellar dislocation. Quality of life was assessed before and after surgery using the Pediatric International Knee Documentation Committee form (Pedi-IKDC), a questionnaire that aims to quantify knee functionality. Postoperative scarring was evaluated using The Stony Brook Scar Evaluation Scale. One hundred and eight patients were selected and grouped according to the type of procedure. Before surgery, the two groups had similar mean Pedi-IKDC scores (41,4 MPFL-R vs. 39,4 LRMI p = 0.314). Improvements were observed in the postoperative scores. The MPFL-R technique showed promising outcomes. When comparing the two surgical groups, there was a significant difference in favor of MPFL-R group (MPFL-R 77.71 points vs. LRMI 59.74 points, p < 0.0001–95% CI (11.22–24.72)). Using the Stony Brook Scar Evaluation Scale, a significant difference in scar quality in favor of MPFL-R was observed (4,5 MPFL-R vs. 2,77 LRMI p = 0.002). In conclusion, this study provides objective evidence-based outcome assessments that support the medial patellofemoral ligament reconstruction technique as the gold standard for patellofemoral instability.

Patellofemoral instability is a common cause of knee pathology that is affecting the quality of life among pediatric population. Methods: We performed a prospective cohort study, including patients that underwent surgical management by using the Lateral Release and Medial Imbrication approach (LRMI) or Medial Patellofemoral Ligament Reconstruction (MPFL-R). The purpose of this study was the assessment of the quality of life among pediatric population that underwent surgery for patellar dislocation. The quality of life was evaluated before and after surgery using the Pediatric International Knee Documentation Committee form (Pedi-IKDC). The postoperative scar was evaluated using The Stony Brook Scar Evaluation Scale. 108 patients were selected and grouped according to the type of procedure. Results: before surgery, the calculated Pedi-IKDC scores were similar between the two groups of patients. We identified substantial improvement in the postoperative score after surgery and the Medial Patellofemoral Ligament Reconstruction technique showed better results. The difference regarding the Pedi-IKDC score between the two groups was significant, in favor of the Medial Patellofemoral Ligament Reconstruction. By using the Stony Brook Scar Evaluation Scale, an important difference emerged between the two groups of patients in favor of the Medial Patellofemoral Ligament Reconstruction technique, revealing that it is a minimally invasive approach, improves recovery, reduces postoperative stay and increases the patients quality of life.Conclusions: This study provides further evidence based results that support the recommendations regarding the Medial Patellofemoral Ligament Reconstruction technique as the gold standard for the patellofemoral instability.Trial registration: The Ethics Committee of „Grigore Alexandrescu” Children’s Emergency Clinical Hospital of Bucharest approved this study on 1st of March 2013. The project code is 7/01.03.2013. An informed parental consent was obtained for every participant.