2024 AANA/ISAKOS Specialty Day All-Access Pass-Case Panel Discussion: Patellofemoral Instability

Video Transcription

Video Summary

The expert panel discussed complex pediatric patellofemoral instability cases, focusing on diagnosis, treatment options, and surgical considerations. A 16-year-old female with bilateral dislocations and patella alta illustrated the importance of correcting patella height and valgus alignment to prevent further damage, especially when osteochondral defects are present. Treatment approaches included distalization and osteotomies, depending on severity and cartilage status. A 17-year-old dancer with acute injury highlighted cartilage repair strategies, such as fixing loose osteochondral fragments using mincing or allografts, along with medial patellofemoral ligament (MPFL) reconstruction for stability. The panel debated fixation techniques and postoperative bracing angles to optimize recovery. Lastly, a 13-year-old male with valgus knees and prior MPFL repair showcased guided growth as a method to correct alignment in skeletally immature patients, coupled with physical therapy and eventual reconstruction. The discussion emphasized individualized treatment based on growth, biomechanical factors, and cartilage health, aiming to restore knee stability and function in young athletes.

Asset Caption

Paul E. Caldwell, M.D., FAANA, Elizabeth A. Arendt, M.D., Kostas John Economopoulos, M.D., Sebastian Irarrazaval, M.D., Amit Momaya, M.D., Diego Perez Salazar Marina, M.D., Norimasa Nakamura, M.D., Ph.D., Petri Sillanpaa, M.D., Ph.D.

Keywords

pediatric patellofemoral instability

patella alta correction

osteochondral defect treatment

MPFL reconstruction

valgus knee guided growth

cartilage repair strategies