APEX Optimizing Surgical Outcomes for Knee & Shoulder Arthroscopy-Track 1: Optimizing Patellar Instability: Lateral Release, Arthroscopic Reefing, MPFL

Track 1: Optimizing Patellar Instability: Lateral Release, Arthroscopic Reefing, MPFL

Video Transcription

Video Summary

Dr. Jesús Ignacio Cardona Medina discusses patellofemoral instability, a common knee injury in young athletes that can lead to osteoarthritis. It mainly affects patients under 20 and results from traumatic disruption of medial patellar structures, often due to knee flexion and valgus stress. Predisposing factors include anatomical abnormalities like trochlear dysplasia, patella alta, high Q angle, generalized hyperlaxity, and muscle contractures. Diagnosis involves clinical evaluation, X-rays, CT to assess alignment, and MRI for ligament or cartilage damage. Treatment must be individualized based on anatomical and soft tissue issues. Non-surgical treatment suits first-time, low-demand athletes but has high recurrence. Surgical options include medial patellofemoral ligament reconstruction, Fulkerson osteotomy for malalignment (medialization and distalization), lateral retinacular release, trochleoplasty for dysplasia, and derotational osteotomies for torsional deformities. Combined procedures are common. Success depends on evidence-based decisions, addressing bone and soft tissue factors to restore stability and function, preventing long-term complications.

Asset Caption

Faculty: Jesus Ignacio Cardona-Medina, M.D.

Keywords

patellofemoral instability

knee injury

young athletes

medial patellar ligament

trochlear dysplasia

surgical treatment