2023 Annual Meeting Knee Access Pass-Salvage Options for the Failed Patellar Stabilization

Salvage Options for the Failed Patellar Stabilization

Video Transcription

Video Summary

Dr. Didook discusses salvage options for failed patellar stabilization, emphasizing the importance of identifying failure causes before revision. Reconstructing the native MPFL anatomy with proper graft placement, often using a gracilis graft, is crucial. Avoid non-anatomic repairs like imbrication, which show no benefit. Anchor fixation on the patella is challenging due to bone quality, so metal anchors or drill holes are preferred. Addressing multiple anatomic risk factors—like patella alta, valgus, torsion, and trochlear dysplasia—is vital, as combined factors greatly increase failure risk. Trochlear convexity causes instability; severe cases may require trochleoplasty. Correcting alignment and vectors is essential for successful outcomes.

Asset Caption

David R. Diduch, M.D.

Keywords

patellar stabilization

MPFL reconstruction

gracilis graft

trochlear dysplasia

trochleoplasty