So You’ve Mastered MPFL Reconstruction: What Else to Add, and When? (AANA22)-Introduction

Video Transcription

So this is ICL 204. Thanks, everyone, for being here. We're talking about patellar-femoral instability. So you've mastered MPFL reconstruction. What else to add and when?  So when it comes to the surgical treatment of patellar instability, we know that it's important to identify and address the individualized pathoanatomy.  So this means looking at the soft tissue deficiency, bony malalignment, and tracheal dysplasia. And when we talk about bony malalignment,  we typically think of tuberosity lateralization, patella alta, and then coronal and rotational abnormalities. When it comes to soft tissue deficiency,  we won't be covering this today. But we all know that the MPFL serves as a primary static restraint to lateral patellar translation. It's injured after patellar dislocation.  And reconstruction of this reduces rates of recurring instability. We also know that anatomic reconstruction is critical in avoiding complications.  And so over time, we've talked about the MPFL, the MQTFL, and now the medial patellofemoral complex. And with this, the rates of patellar stabilization surgery  have been increasing over the past 10 to 15 years. But we also know that the rates after the surgery can be as high as 26%. And avoiding complications, particularly  with ligament reconstruction, involve having appropriate graft length and tension, anatomic tunnel positioning. And most importantly, what we're talking about today  is adding concurrent procedures when they're indicated.  I'm honored to be working with an incredible panel today. So we have Seth Sherman from Stanford, Andy Kosgaria from Johns Hopkins, and Liza Arendt from the University of Minnesota.  So what we'll be covering today, we'll start with a discussion of coronal and rotational malalignment. And then we'll talk about patella alta, trochlear abnormalities.  And we'll finish with lateral soft tissues. We're actually going to incorporate the case discussions into the talks, but we'll save the last minutes for our Q&A.

Video Summary

In this video, the speaker discusses the surgical treatment of patellar-femoral instability, specifically focusing on identifying and addressing individualized pathoanatomy, including soft tissue deficiency, bony malalignment, and trochlear dysplasia. They emphasize the importance of anatomic reconstruction to reduce rates of recurring instability and avoid complications. The panel of experts, including Seth Sherman, Andy Kosgaria, and Liza Arendt, will cover topics such as coronal and rotational malalignment, patella alta, trochlear abnormalities, and lateral soft tissues. The video will incorporate case discussions and end with a Q&A session.

Asset Caption

Miho J. Tanaka, M.D., M.A., Seth L. Sherman, M.D., Andrew J. Cosgarea, M.D., Elizabeth A. Arendt, M.D.

Keywords

surgical treatment

patellar-femoral instability

pathoanatomy

anatomic reconstruction

trochlear dysplasia