Complications – Surgeons' Worst Enemy & Best Teacher (2021 Annual Meeting)-Complications - Surgeons' Worst Enemy & Best Teacher-Brady

Video Transcription

Video Summary

Beth Shubin Stein’s talk focuses on patellofemoral surgery, emphasizing the importance of accurately diagnosing whether a patient’s issue is pain, instability, or both before surgery. MPFL reconstruction is usually sufficient for cases without severe anatomical abnormalities; however, additional procedures like tibial tubercle osteotomy (TTO) may be necessary for significant malalignment or cartilage damage. Key surgical tips include precise femoral tunnel placement to ensure graft isometry, avoiding patellar fracture risks, and careful tensioning of the graft to prevent complications. In cases of failed MPFL, understanding the cause is critical before revision. The discussion also highlights practical surgical challenges, such as graft contamination and management, and advises open, honest communication with patients about intraoperative issues without causing alarm. Postoperative follow-up and team-based patient communication strategies are recommended. Lateral releases are rarely done due to risks, especially in ligamentous laxity. Overall, the approach stresses individualized treatment planning, surgical precision, and transparent patient care.

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Dr. Jacqueline Brady

Keywords

patellofemoral surgery

MPFL reconstruction

tibial tubercle osteotomy

femoral tunnel placement

graft tensioning

patient communication