IC 11-2026-Managing and Avoiding Complications during Patellar Stabilization Surgery-IC 11-2026-Managing and Avoiding Complications during Patellar Stabilization Surgery

Video Transcription

Video Summary

This session focused on preventing, recognizing, and treating complications during patellar stabilization surgery, especially MPFL/MPFC reconstruction, tibial tubercle osteotomy (TTO), and lateral-sided procedures.<br /><br />The opening speaker emphasized that patellar instability treatment must be individualized based on anatomy, often combining soft tissue reconstruction with bony procedures. Common complications after MPFL surgery include patellar fixation failure, femoral tunnel malposition, over-tightening, pain, stiffness, and recurrent instability. A case example showed patellar anchor pullout causing medial prominence and symptoms, highlighting the need for alternative fixation or soft-tissue-based revision options when patellar bone stock is limited. Another case illustrated how an overly distal or tight graft can cause pain and loss of motion; selective release of a tight graft bundle restored motion and function.<br /><br />Dr. Sherman then discussed failed MPFL reconstruction more broadly. He stressed that recurrent symptoms require careful history, physical exam, imaging, and assessment of malalignment, patella alta, trochlear dysplasia, version, and valgus. He emphasized that many failures reflect aberrant force vectors rather than isolated ligament problems, and that revision surgery often requires combining MPFL revision with TTO, osteotomy, or trochleoplasty when thresholds are met.<br /><br />Dr. Strickland reviewed TTO complications, including undercorrection, malunion, delayed union, nonunion, tibial fracture, and patella baja. She highlighted that persistent malalignment is a common reason for revision and described technical pearls to improve distalization accuracy and fixation strength.<br /><br />Dr. Yanke concluded by covering lateral retinacular procedures, warning that lateral release can create medial instability if overdone. He advocated for careful use of lateral lengthening or reconstruction only in selected cases.<br /><br />Overall, the panel stressed precise diagnosis, anatomy-based planning, and avoiding over-constraint.

Keywords

patellar stabilization surgery

MPFL reconstruction

MPFC reconstruction

tibial tubercle osteotomy

patellar instability

revision surgery

femoral tunnel malposition

patellar fixation failure

lateral retinacular release

over-constraint