Inside Pediatrics Spring/Summer 2026

ORTHOPEDICS

Reconstruction Reimagined

CHILDREN’S SURGEONS ARE TAKING A NEW APPROACH FOR TREATING PATELLAR INSTABILITY

F or Kevin Williams, M.D., and the Children’s of Alabama orthopedic team, patellar instability is a commonly seen problem. The condition—in which the kneecap repeatedly slips out of place—and all of its inherent challenges have been the subject of much discussion worldwide recently, Williams says. But he and his team have developed a solution—a modified procedure that combines existing, well-established methods and is already showing promise.

Kevin Williams, M.D.

The procedure is called medial patellofemoral ligament (MPFL) reconstruction. Williams and his team began developing a modified version of it about two years ago and refined

it in 2025. They’ve used it on approximately 15–25 patients, and the results have been encouraging. “Children and adolescents that are still growing and developing have been able to get back to doing activities they enjoy—like dancing and gymnastics—faster compared with our previous, more invasive procedures,” he said. “Complications have been scarce so far in the early stages of this modified procedure.” THE CHALLENGES OF PATELLAR INSTABILITY The procedure treats a problem that is challenging for several reasons, perhaps most notably the various ways patellar instability can present. In some cases, a child might have been born with a kneecap problem or developed it early in childhood, which means the body is used to the anomaly. When treating children,

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