AANA19 Knee Access Pass-Rapid Fire Cases_ Concurrent Scientific Session 1_ Symposium - Patella Challenges and Treatments-Dr. John P. Fulkerson, M.D.

Rapid Fire Cases_ Concurrent Scientific Session 1_ Symposium - Patella Challenges and Treatments-Dr. John P. Fulkerson, M.D.

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Video Transcription

Video Summary

This detailed discussion focuses on managing patellar dislocations, particularly lateral patellar dislocations and associated knee injuries. Experts review imaging findings, surgical indications, and fixation techniques, emphasizing precise anatomical identification and isometry checks for successful medial patellofemoral ligament (MPFL) reconstruction. Various intraoperative imaging tools, including fluoroscopy and ultrasound, are debated for locating optimal graft placement. The conversation highlights balancing graft tension—avoiding overtightening to prevent complications—and the role of lateral retinacular lengthening or release depending on the case. Osteotomy techniques for tibial tubercle transfer are covered with tips on fixation to minimize post-op irritation or fractures. A complex case of a young athlete with multi-ligament injury and patellar instability illustrates aggressive surgical repair combining ACL and meniscal repairs with MPFL reconstruction, enabling her to compete successfully postoperatively. Overall, the session underscores individualized treatment strategies for patellofemoral instability and review of advanced surgical techniques to optimize patient outcomes.

Keywords

patellar dislocation

medial patellofemoral ligament reconstruction

intraoperative imaging

graft tension management

tibial tubercle osteotomy

multi-ligament knee injury