ICL 306: Avoiding Complications in Patellofemoral Instability Surgery: MPFL Reconstruction-Medial Patellar Instability

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Video Summary

The presentation focuses on medial patellar instability, often occurring after lateral release surgery. Two cases of women with previous lateral releases showed significant medial patellar translation and instability, initially misdiagnosed and recommended for inappropriate surgeries. Clinical examination, especially under anesthesia, and medial patellar apprehension are key diagnostic tools, as imaging may be inconclusive. Treatment involves lateral retinacular repair or reconstruction—often using a graft from the iliotibial band—to restore lateral support. Over-tightening should be avoided, and lateral stability reassessed post-repair. Isolated lateral release is generally contraindicated for patellar instability, and a history of lateral release should prompt evaluation for medial instability to guide proper management.

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Presented by Miho Tanaka, MD

Keywords

medial patellar instability

lateral release surgery

medial patellar apprehension

lateral retinacular repair

iliotibial band graft