Background: The aim of this study was to evaluate the outcome of pediatric patellofemoral pain and instability from subluxation treated with a soft-tissue realignment. Methods: The patients were sent a blinded questionnaire by mail. In total, 44 patients (55 operative knees) responded. Patients were divided into three follow-up groups: less than 2 years, 2-5 years and greater than 5 years, with the average length of follow-up being 6 years and 1 month. Results: There was statistical significance between those with improved knees with less than 5 years follow-up compared with those with over 5 years follow-up. Outcomes were significantly worse after the 5-year mark. Conclusion: This study adds to the total body of knowledge of instability associated with patellofemoral pain in the pediatric population and is unique because it includes only pediatric patients with long-term follow-up. While short-term results for soft-tissue realignment procedure of the patella, up to 5 years, yielded generally a good outcome, follow-up of more than 5 years was consistent with markedly worse results. Unfortunately, this remains a common and difficult problem in this age group.
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