Patellofemoral Case Study: Patella Instability, High TT-TG, Patella Alta + Trochlear Dysplasia in a Skeletally Mature Female

Severe patella instability in the context of significant bony abnormalities creates a challenging clinical situation. In this clinical vignette, a 17-year-old young woman presented with daily patella instability and extreme patella alta, a significantly laterally displaced tibial tubercle, and severe trochlear dysplasia. Treatment with medial patellofemoral ligament reconstruction and tibial tubercle osteotomy was performed, but she continued to have persistent instability complaints. A trochleoplasty was first performed on a 3-D printed model of the knee, and subsequently on the patient. Successful stability was achieved. Four surgeons discuss the case and their perspective on treatment.