2024 AOSSM Annual Meeting Recordings NON-CME-Concurrent Session A Get Yourself in Line- Best Patellofemoral Practices

Video Transcription

Video Summary

The video presentation covered several academic presentations and subsequent discussions around clinical studies and techniques in the field of patellofemoral instability treatment. The session included detailed insights into different surgical procedures, clinical outcomes, and studies focusing on various aspects of patellofemoral joint instability and associated injuries.<br /><br /><h3>Presentation and Studies on Patellofemoral Instability Treatment:</h3><br />- <strong>Joshua Graham’s Presentation</strong>: Focused on the correlation between multiple patellar dislocation events and chondral damage in the trochlear region. It was highlighted that higher dislocation rates (beyond five) contribute to more severe trochlear lesions. Patient demographics primarily included younger individuals, mostly females, and emphasized the need for early intervention to avoid chronic instability and subsequent damage.<br />  <br />- <strong>Sam Montgomery’s Presentation</strong>: Compared the outcomes of isolated MPFL (medial patellofemoral ligament) reconstruction vs. MPFL with concomitant Tibial Tubercle Osteotomy (TTO). The study highlighted that both procedures have similar rates of return to sport, although the combined procedure took longer to return to sports but offered better overall outcomes in specific patient profiles.<br /><br />- <strong>Bob Magnuson’s Presentation</strong>: Delved into MPFL reconstruction outcomes for patients over 30 years. Despite age being a factor, similar instability rates were observed compared to younger demographics. Older patients did report higher levels of pain post-surgery, suggesting potential age-related factors affecting recovery.<br /><br />- <strong>Kurt Campbell’s Presentation</strong>: Examined and compared the clinical outcomes and return to sport rates between osteochondral allograft transplantation and autologous chondrocyte implantation (MACI) for treating patellofemoral articular lesions. Clinical outcomes were similar for both procedures, although larger lesion sizes generally resulted in poorer outcomes.<br /><br /><h3>Surgical Techniques Discussed:</h3><br />1. <strong>Thin Flap Groove Deepening Trochleoplasty</strong> by Lee Pace: Aimed to correct high-grade trochlear dysplasia by creating a new groove in the trochlea through an osteochondral flap technique.<br />  <br />2. <strong>Medial Patellofemoral Complex (MPFC) Reconstruction</strong> by Miho Tanaka: Focused on a technique incorporating the quadriceps tendon to minimize risks such as patella fractures, highlighting the need for correct anatomical fixation points to ensure stable outcomes.<br />  <br />3. <strong>Tibial Tubercle Osteotomy (TTO)</strong> by Jackie Brady: Covered the medialization, anterior medialization, and distalization techniques for TTO to correct patellar instability and other related complications with precise surgical steps.<br /><br /><h3>Debate:</h3><br />The session concluded with a lively debate on whether isolated MPFL reconstruction is sufficient to address patellar instability, moderated by Drs. Schubenstein and Farrow. The debate underscored varying perspectives on incorporating bony procedures like TTO to ensure comprehensive treatment, finally culminating in a participant vote, favoring the inclusive approach championed by Dr. Farrow.<br /><br />Overall, the session reflected a critical evaluation of current practices, emerging techniques, and the continuous endeavor towards optimized patient outcomes in treating patellofemoral instability.

Asset Caption

2:20 pm - 3:20 pm

Meta Tag

Concept Patellar Dislocation

Concept Isolated MPFL Reconstruction

Concept Patellofemoral Osteochondral Defect

Concept Medial Patellofemoral Ligament Reconstruction

Concept Cartilage Damage

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

patellofemoral instability

surgical procedures

clinical outcomes

patellar dislocation

MPFL reconstruction

Tibial Tubercle Osteotomy

osteochondral transplantation

trochleoplasty

articular lesions

patient demographics

Patellar Dislocation

Isolated MPFL Reconstruction

Patellofemoral Osteochondral Defect

Medial Patellofemoral Ligament Reconstruction

Cartilage Damage