2023 Annual Meeting Knee Access Pass-Panel Discussion

Video Transcription

Video Summary

The panel discussion focused on various pediatric and adolescent patellar instability cases, emphasizing rapid decision-making based on history, exam, and imaging. For a 14-year-old with mild trochlear dysplasia and patellar apprehension, there was a consensus for isolated MPFL reconstruction. A 13-year-old with borderline patella alta and ligamentous laxity prompted debate on adding tibial tubercle distalization alongside MPFL reconstruction, considering growth and anatomy. Cases involving osteochondral fractures emphasized fixation with trans-osseous sutures. For severe trochlear dysplasia with large trochlear spurs and cartilage lesions, panelists favored combined procedures: MPFL reconstruction, tibial tubercle osteotomy (TTO), trochleoplasty, and cartilage restoration as needed. They highlighted tailoring surgery to symptoms, dynamic tracking, and growth status, often staging interventions. The discussion underscored the complexity of balancing anatomy, instability, and cartilage health, advocating for individualized approaches like provisional tubercle correction before trochleoplasty. The session concluded stressing multidisciplinary evaluation, surgical precision, and patient-specific strategies for returning to sports and improving knee stability.

Asset Caption

Moderators: Cory Edgar, M.D., Ph.D., Lee Pace, M.D.
Panelists: David D. Diduch, M.D., Jacqueline M. Brady, M.D., Beth E. Shubin-Stein, M.D., Miho J. Tanaka, M.D., M.A., Adam B. Yanke, M.D., Ph.D.

Keywords

pediatric patellar instability

MPFL reconstruction

trochlear dysplasia

tibial tubercle osteotomy

osteochondral fracture fixation

individualized knee surgery