IC 307

Patellar Instability: When is an MPFL Reconstruction just not enough! A Case-Based Discussion  

Course Description:

The management of patellofemoral instability remains a complex and challenging algorithm for treating surgeons.  A variety of anatomical factors, including osseous morphology and soft tissue injury and laxity influence decision-making to minimize the risk for recurrence and failure.  Chondral status associated intra-articular injuries, and patient-specific goals and expectations further complicate decision-making.  Rehabilitation and return to play continue to evolve as well with improved techniques to protect repairs and assess functional progress.  This ICL will feature key opinion leaders in patellofemoral instability and will feature case vignettes ranging from simple to highly complex injury patterns for discussion.  Physical examination, critical evaluation of imaging, and considerations for intraoperative decision-making will be reviewed.  Technical pearls for MPFL reconstruction, trochleoplasty, tibial tubercle osteotomy, and femoral derotational osteotomy will be provided, and the rehabilitation approach and timelines for return to sport discussed.  Complications and their management will also be reviewed by faculty.

Learning Objectives:

• Identify the osseous and soft tissue factors contributory to greater risk of patellar instability, and failure after isolated MPFL reconstruction surgery.
• Recognize the need for associated osteotomy and/or trochleoplasty and the indications for these interventions in additional to MPFL reconstruction.
• Review the indications, technical considerations, and outcomes associated with MPFL reconstruction surgery for patellar instability.
• Review the options for associated correction in additional to MPFL reconstruction in the at-risk knee to minimize risk of recurrent instability.

Faculty:

Asheesh Bedi, MD

David R. Diduch, MD

Jason L. Koh, MD

Beth E. Shubin Stein, MD

Sabrina M. Strickland, MD