Patella Instability Didactic Presentations - AOSSM/POSNA Pediatric Surgical Skills Course-1. The Basics of a Physeal Sparring Medial Patellofemoral Complex Reconstruction

1. The Basics of a Physeal Sparring Medial Patellofemoral Complex Reconstruction

Video Transcription

Video Summary

In this video, Todd Lawrence from the Children's Hospital of Philadelphia discusses the basics of MPFL surgery in kids. He reviews anatomical and biomechanical principles related to the soft tissue restraints on the patella and explains how they are applied in MPFL reconstruction in immature patients. Lawrence emphasizes that MPFL reconstruction is a good option for addressing lateral dislocation in most immature patients, but in some cases, it may work as a tether when other options are not feasible. He also discusses the importance of femoral attachment and explains different techniques for MPFL reconstruction. Lawrence highlights the effectiveness of isolated MPFL reconstruction, with low redislocation rates and improved patient-reported outcomes. He provides a detailed description of his preferred surgical technique, including graft selection, femoral attachment, tensioning, and fixation. Lawrence concludes by emphasizing the benefits of dynamic tensioning and recommends staying completely epiphyseal in patients with significant growth remaining. He also provides post-operative guidelines and timeline for returning to activities.

Keywords

MPFL surgery

soft tissue restraints

MPFL reconstruction

femoral attachment

patient-reported outcomes