2024 AANA/ISAKOS Specialty Day All-Access Pass-Introduction to Session V: Patellofemoral & Debate Introduction: First-Time Dislocator in a School Level Rugby Player With No Cartilage Defect and a High Chance of Making Pro Level

Introduction to Session V: Patellofemoral & Debate Introduction: First-Time Dislocator in a School Level Rugby Player With No Cartilage Defect and a High Chance of Making Pro Level

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Video Transcription

Okay, thank you so much for that fantastic discussion on cartilage. We now move to the last part of the knee group, and we're going to be discussing now the patellofemoral joint.  And it's a great pleasure to invite Dr. Degut Figueroa from Chile, as well as Dr. Miho Tanaka from the Anna side. And all yours. Thank you. Thank you, and I'm happy to be here,  chairing with you in the next minutes. We are talking about the very common problem, the primary patellofemoral dislocation we are clinically facing every day.  I'm Dr. Figueroa from Chile, representing ISACOS. With me as co-moderator, Dr. Miho Tanaka from Harvard University. We have outstanding speakers, Dr. Corey Edgar from Connecticut,  and Dr. Laurie Himstra from Banff Sports Horto. So let's go with the case, Miho. Excellent. Thank you very much. Welcome, everybody.  So as we know, for patellar dislocations, there's a lot of different options, although I see someone left off the MQTFL from this picture here. So today we have our debates.  We'll get started with this case. So this is a first-time lateral patellar dislocation in a school-level rugby player, 15 years old, BMI of 22.  He's a student who enjoys playing rugby, but is seriously considering going pro in the future, as they all are. He gets side-tackled during training.  Lateral patellar dislocation of the right knee. You can see the MRI here. This is reduced on field with the assistance of his coach.  You can see some bone marrow edema and the injury to the MPFL or MPFC on the axial view. He presents in clinic four days later. He has anxious parents.  He has medial patellar tendinitis and limited range of motion, small effusion, weak quadriceps, and he presents on crutches. You can see this avulsion off the medial facet here.  TTTG distance on MRI is 10 millimeters. No trochlear dysplasia. Normal patellar height. Neutral alignment. Oops, sorry. Okay. So here we have our debate.  Corey Edgar is going to be talking about primary MPFL repair, and Lori Heemstra is going to be talking about nonoperative management. Dr. Edgar, can we have you come up?

Video Summary

The discussion moves to the patellofemoral joint focusing on primary patellofemoral dislocation. Dr. Figueroa and Dr. Tanaka lead the conversation with Dr. Edgar and Dr. Heemstra as speakers. A case of a 15-year-old rugby player with a lateral patellar dislocation is presented, showing bone marrow edema and MPFL injury on MRI. Treatment options are debated; Dr. Edgar discusses primary MPFL repair, while Dr. Heemstra advocates for nonoperative management. Details such as the TTTG distance and anatomical findings are highlighted. The session delves into the complexities of managing patellar dislocations in young athletes aiming for professional careers.

Asset Caption

Sachin Ramchandra Tapasvi, M.D.,M.B.B.S.,M.S. & Miho Jean Tanaka, M.D., Ph.D.

Keywords

patellofemoral joint

primary patellofemoral dislocation

MPFL injury

lateral patellar dislocation

treatment options