Der Unfallchirurg
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Dislocation of the patella represents a frequent knee problem in childhood and adolescence. There are traumatic, recurrent, habitual and chronic forms. Many anatomical variations, which promote patellar dislocation, are known. ⋯ Recurrent, habitual and chronic dislocations are best cured surgically by vastus medialis advancement, reconstruction of the medial patellofemoral ligament, strengthening of the medial retinaculum together with a lateral release and by fixation of the patella using tendon grafts or medialisation of the insertion of the patellar ligament. To improve the femoropatellar groove by trochleoplasty is a different surgical concept. The long-term results following medialisation of the patellar ligament insertion or trochleoplasty are good with regards to patellar stability but mediocre in terms of avoiding degenerative changes in the patellofemoral joint.