Parikh, Shital N. MD 1; Albright, Jay MD 2; Noyes, Frank R. MD 3
Patellofemoral malalignment is a common cause of anterior knee pain or patellofemoral instability. Although most of these patients respond favorably to conservative treatment, surgical treatment is required for recalcitrant patients with patellofemoral malalignment. Many surgical procedures have been described for proximal and distal realignment of patellofemoral mechanism. We describe our surgical technique of lateral retinacular release, proximal realignment with vastus medialis obliquus (VMO) advancement and distal realignment by medial transfer of the tibial tubercle, using a minimally invasive approach. Specifically highlighted is the use of the quadriceps tendon for reconstruction of the medial patellofemoral ligament (MPFL) when deficient or thin medial tissues are present. The described approach is cosmetically acceptable, has minimal morbidity, and allows rapid rehabilitation with improved patellofemoral alignment.
Techniques in Knee Surgery. 5(1):27-38, March 2006.