Video Gallery

Video Gallery

To View the Video

Treatment Algorithm for Complex Patellofemoral Problems

February 19, 2016

Contributors: Michael G Saper, DO, ATC; David A Shneider, MD; David A Shneider, MD

The management of complex patellofemoral problems via a treatment algorithm allows for accurate evaluation and assessment, the development of a treatment plan, and systematic surgical correction. At each step, the algorithm suggests the correct path to move to the next step. Examination under anesthesia and arthroscopy can then be used to validate the treatment plan. The surgical plan is then carried out according to each step suggested by the algorithm and changed if necessary based on the surgical findings, and correction is obtained based on the prior steps. Various techniques are available to accomplish each step of the correction. For example, medial patellofemoral ligament reconstruction is performed with the use of quadriceps tendon, semitendonosis tendon, or allograft tendon without drilling into the patella, even if a patellar prosthesis is in place. Tibial tubercle transfer is included, with the correction of patella alta if necessary. Use of the algorithm and steps are demonstrated in a 23-year-old woman with a patella that had been dislocated since she was aged 8 years; the dislocated patella was never managed. Articular cartilage on the femoral trochlea was widely absent, and the patella had extensive damage. Clinical follow-up with range of motion and ambulation is included in the video. This algorithm allows for a systematic approach to complex patellar problems, including evaluation, assessment, surgical planning, intraoperative monitoring of progress, and final outcome. The principles of this algorithm can be used for the management of all patellar problems and are not confined to complex patients.

Results for "Knee Preservation"

2 of 4
2 of 4

X