Description
The Patella Instability Symposium is a focused discussion led by Dr. Bobby Anand, emphasizing the complexities of surgical decision-making concerning patella instability over approximately 15 minutes. Dr. Anand begins with an overview of managing first-time patellar dislocations, generally advocating for non-surgical approaches, supported by findings from a systematic review that suggested higher re-dislocation rates in conservatively treated patients. He stresses the importance of thorough risk assessment for each patient, utilizing imaging studies such as x-rays and MRIs to identify anatomical factors that may influence treatment options.
For patients with recurrent patella instability, Dr. Anand references recent consensus statements highlighting the ineffectiveness of lateral release procedures and the prevalent use of Medial Patellofemoral Ligament (MPFL) reconstruction, which reportedly shows promising outcomes, though complications such as technical failures and significant bony pathology can lead to a higher incidence of re-dislocations.
The discussion extends to the impacts of trochlea dysplasia and patella alta on surgical outcomes, reinforcing the necessity of addressing underlying bony issues in addition to soft tissue procedures. Dr. Anand shares various clinical cases and highlights the role of complex procedures such as trochleoplasty in patients with significant dysplasia, noting the favorable results in recent studies supporting this approach.
He concludes with a call for cautious application of trochleoplasty and clear communication regarding its complexity, emphasizing that such surgeries should be reserved for experienced surgeons within specialized settings. The symposium encapsulates the clinical challenges in treating patella instability, advocating for tailored approaches that prioritize patient-specific anatomical considerations.