Chronic Patellar Instability

COLORADO SPRINGS, Colo. —With no differences in failure rates, patient-reported outcomes, pain or return to play, both allograft and autograft are viable options for patients undergoing medial patellofemoral ligament reconstruction.

SAN FRANCISCO — At the Arthroscopy Association of North America Annual Meeting, Miho J. Tanaka, MD, discussed acceptable variations and surgical techniques for medial patellofemoral complex reconstruction.

Published results showed appropriately selected patients with patellofemoral instability after total knee arthroplasty may experience satisfactory results when treated with medial patellofemoral ligament reconstruction.

This is a timely question.

A 7-year-old girl with asymmetric dystonic diplegic cerebral palsy, hydrocephalus with ventriculoperitoneal shunt and Williams syndrome had progressive left patellar instability. She had a gross motor function classification system level 1.

Combined reconstruction of the medial patellofemoral ligament and the medial quadriceps tendon-femoral ligament may provide a more anatomical, less invasive alternative technique for patellar instability, according to researchers.

Since describing anteromedialization tibial tubercle osteotomy for realignment and unloading of the patella in 1983, I have done about 1,500 anteromedial tibial tubercle transfers.

Results showed medial patellofemoral ligament reconstruction with and without tibial tuberosity osteotomy yielded similar outcomes for patients with patellar instability and a tibial tuberosity-trochlear groove distance of 15 mm to 25 mm.

NASHVILLE, Tennessee — In this video from the American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting, Seth L. Sherman, MD, discussed the evolution of tibial tubercle osteotomy.

Medial patellofemoral ligament reconstruction may be a safe and effective treatment option for adolescent patients with patellar dislocations and instability, according to published results.