2024 AOSSM Annual Meeting Recordings-Concurrent Session A: Get Yourself in Line

Video Transcription

Video Summary

In the video session, multiple speakers covered various topics related to patellar dislocation and procedures for stabilization. Initially, housekeeping details were addressed including the session's schedule, which consisted of paper presentations, technique discussions, and a concluding debate.<br /><br />The first paper by Joshua Graham from HSS explored patellar dislocation events and their association with chondral damage, finding increased trochlear lesions in multiple dislocation cases. Surgery after more than five dislocations reduces chondral damage.<br /><br />Sam Montgomery’s research from NYU compared return to sports in MPFL reconstruction alone versus combined with tibial tubercle osteotomy (TTO). The study concluded similar psychological readiness and return-to-sport rates, though isolated MPFL led to faster recovery.<br /><br />Bob Magnuson presented outcomes of MPFL reconstruction in patients over 30, noting similar dislocation rates but increased pain and decreased activity levels in older patients.<br /><br />Kurt Campbell analyzed clinical outcomes of osteochondral allografts and autologous chondrocyte implantation (MACI) for patellofemoral joint articular lesions, finding similar improvements in patient-reported outcomes. However, patients with allografts, particularly for trochlear lesions, reported higher pain.<br /><br />Lee Pace demonstrated his technique for thin flap groove deepening trochleoplasty, ensuring stability through careful osteochondral flap elevation and reconstruction while avoiding over-tensioning to prevent cartilage damage.<br /><br />Miho Tanaka's video focused on anatomical MPFL reconstruction, primarily via quadriceps tendon fixation, emphasizing proper tunnel placement and intraoperative checks to ensure isometric scaling.<br /><br />Jackie Brady provided a comprehensive guide on tibial tubercle osteotomy, highlighting key procedural details to avoid complications such as maintaining bone stability and appropriate medialization or anteromedialization techniques using standard OR tools.<br /><br />The concluding debate featured Dr. Schubenstein advocating for isolated MPFL reconstruction citing good outcomes and shorter recovery, while Dr. Farrow argued for combined NPFL and TTO in cases with significant anatomical deviations, reinforcing the need for comprehensive correction to ensure stability and proper knee function. An audience vote concluded the session, indicating a preference for Dr. Farrow's approach.

Asset Caption

2:20 pm - 3:20 pm

Meta Tag

Concept Patellar Redislocation

Concept Patellofemoral Articular Lesion

Concept Medial Patellofemoral Ligament Reconstruction

Concept Cartilage Damage

Concept Fresh Osteochondral Allograft Transplantation

Speaker Elizabeth A. Arendt, MD

Speaker Miho Tanaka, MD, PhD

Speaker Joshua T. Bram, BS

Speaker Samuel Montgomery, Jr., MD

Speaker Robert A. Magnussen, MD, MPH

Speaker Kirk Campbell, MD

Speaker Jacqueline M. Brady, MD

Speaker James L. Pace, MD

Speaker Beth E. Shubin Stein, MD

Speaker Lutul Farrow, MD

Keywords

Elizabeth A. Arendt, MD

Miho Tanaka, MD, PhD

Joshua T. Bram, BS

Samuel Montgomery, Jr., MD

Robert A. Magnussen, MD, MPH

Kirk Campbell, MD

Jacqueline M. Brady, MD

James L. Pace, MD

Beth E. Shubin Stein, MD

Lutul Farrow, MD

patellar dislocation

MPFL reconstruction

tibial tubercle osteotomy

trochlear lesions

chondral damage

osteochondral allografts

autologous chondrocyte implantation

trochleoplasty

quadriceps tendon fixation

knee stabilization

Patellar Redislocation

Patellofemoral Articular Lesion

Medial Patellofemoral Ligament Reconstruction

Cartilage Damage

Fresh Osteochondral Allograft Transplantation