IC 308-2024: Management of Patellofemoral Instability and Chondral Lesions in The Young Patient: Focus on Stabilization and Cartilage Restoration-IC 308: Management of Patellofemoral Instability and Chondral Lesions in The Young Patient: Focus on Stabilization and Cartilage Restoration

IC 308: Management of Patellofemoral Instability and Chondral Lesions in The Young Patient: Focus on Stabilization and Cartilage Restoration

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Video Transcription

Video Summary

This video transcript is an in-depth educational session on patellofemoral instability hosted by Alex Galant from NYU, featuring contributions from renowned experts including Dr. Lee Pace from Texas, Jackie Brady from Oregon, and Kirk Campbell from NYU. The session begins with an overview of patellofemoral instability, its essential nature, and its high recurrence rates, particularly in teenagers. The focus centers on medial soft tissue disruptions and the dynamic imbalance they cause in knee stability.<br /><br />Several treatment options are discussed, including repair versus reconstruction. Galant emphasizes that reconstruction is typically favored over repair due to significantly lower failure rates. He explores different surgical techniques, graft choices, and specific components of the medial patellofemoral complex (MPFC) like MPFL (Medial Patellofemoral Ligament) and MQTFL (Medial Quadricep Tendon-Femoral Ligament).<br /><br />Jackie Brady then elaborates on the importance of a tibial tubercle osteotomy (TTO) in treating patellar instability, stressing the need to address various anatomical misalignments that contribute to patellar instability. Studies are cited to show differing results on the efficacy of TTO, particularly in combination with MPFL.<br /><br />Further in the session, Dr. Lee Pace advocates for trochleoplasty, a surgical procedure to reshape the dysplastic trochlea to treat patellar instability. Various outcomes from numerous studies are discussed, highlighting the procedure's effectiveness and long-term reliability.<br /><br />Lastly, Kirk Campbell discusses the role of cartilage restoration techniques in patellofemoral procedures. Options like MACE, de novo particulated juvenile cartilage allograft, and osteochondral allograft are examined for their effectiveness and patient outcomes.<br /><br />Clinical cases are presented to exemplify these techniques and provide real-world context to treatment decisions. These highlight differing approaches by the panel, illustrating how personalized treatment plans are crafted based on detailed patient assessments and the surgeon's expertise.

Keywords

patellofemoral instability

Alex Galant

NYU

Dr. Lee Pace

Jackie Brady

Kirk Campbell

medial soft tissue

reconstruction

MPFL

tibial tubercle osteotomy

trochleoplasty

cartilage restoration

clinical cases