So You’ve Mastered MPFL Reconstruction: What Else to Add, and When? (AANA22)-Coronal_Rotational Malalignment and Anteromedialization Type TTO

Video Transcription

Video Summary

Dr. Seth Sherman from Stanford discusses the complexities of coronal and rotational malalignment in patellofemoral instability. He emphasizes the importance of understanding bony malalignments over solely relying on soft tissue stabilization like MPFL reconstruction. Sherman highlights that isolated medial patellofemoral ligament (MPFL) repairs often fail in cases featuring complex malalignments, such as valgus deformity, femoral rotation, and tibial torsion. He questions the traditional reliance on tibial tubercle lateralization (TTTG) as the primary driver for surgery, noting its variability and the significance of femorotibial rotation. Surgical strategies should be individualized, employing techniques like derotational osteotomy, trochleoplasty, or tibial tubercle osteotomy, depending on specific anatomical abnormalities and cartilage condition. Sherman advocates for advanced imaging, precise measurements, and interdisciplinary collaboration for better diagnosis and treatment planning. He also encourages ongoing research, including machine learning, to better understand and treat patellofemoral instability beyond standard protocols.

Asset Caption

Seth L. Sherman, M.D.

Keywords

patellofemoral instability

coronal malalignment

rotational malalignment

medial patellofemoral ligament (MPFL) reconstruction

derotational osteotomy