[Advances on the treatment of the first-time patellar dislocation in children and adolescents].

The first patellar dislocation in children and adolescents is a common clinical sports injury. The controversy in the treatment strategies poses a significant challenge to long-term functional prognosis of patients. Studies have shown that demographic factors (young age, female gender), skeletal maturity, and anatomical abnormalities (such as trochlear dysplasia (TD), increased distance between tibial tubercle and trochlear groove (TT-TG) were closely related to patellar dislocation. Although conservative treatment is the preferred option, it has a high recurrence rate and is prone to leaving knee joint dysfunction; surgical treatment, such as medial patella femoral ligament reconstruction (MPFLR) and trochlear reshaping, has gradually become an important choice for patients with moderate to high risks (those with bone and cartilage fractures, Dejour-B-D type trochlear dysplasia, or those who fail conservative treatment). Currently, research focuses on optimizing individualized surgical plans based on anatomical risk stratification, improving bone and cartilage protection techniques, and evaluating efficacy of combined treatment modalities. The author believes that the treatment of the first patellar dislocation should take into account anatomical features, skeletal maturity, and functional requirements, and prioritize conservative treatment combined with early rehabilitation;however, for high-risk patients (such as TT-TG > 20 mm, severe trochlear dysplasia), individualized surgical intervention should be actively implemented to reduce recurrence rates and improve prognosis.