Current Concept Review: Patellofemoral Instability in Children with Down Syndrome

The incidence of patellofemoral instability (PFI) in patients with Down syndrome (DS) is 10-20%. Treatment of PFI in this cohort has evolved over the past four decades. Non-operative management largely prevail today, however symptomatic patients with DS and recurrent instability may benefit from patellar stabilization surgery. Combined, physeal-sparing soft tissue procedures have become the focus of modern-day surgeons when operative intervention is pursued in skeletally immature patients. This review article outlines the seldomly discussed topic of PFI in patients with DS and highlights the need for high quality, outcome-based research on the optimal management in this specific cohort. Key Concepts ● Asymptomatic patients with Down Syndrome (DS) and patellofemoral instability (PFI) are treated non-operatively. ● Surgical treatment of PFI has evolved and may benefit patients with DS and symptomatic PFI. ● Approximately 20% of patients with DS develop PFI. Reported recurrence rates following surgical intervention range from 0% to 20%. ● High quality, outcome-based research in this population is needed.