We have a 18 yr old aspiring nurse with H/0 of recurrant dislocation patella and peripatellar pain. o/e. She has mild ligamentous laxity, No end point of MPFL with definite medial patellar laxity, +ve apprehension for patellar instabity, normal TT/TG distance, no lateral femoral condyle hyoplasia, bilateral increased femoral anteversion value- 25 degrees. She need to join college in 6 weeks. No instabilty in the opposite knee but has patellofemoral pain(lateral facet)
Do we correct anteversion first or MPFL reconstruction first or do we do both simultaneously. Do we use a IM Nail to stabilse the osteotomy? Not much of a fan of plates.
Had a comment from Dr. Sachin Tapasvi suggesting MPFL first and Big b suugesting de rotation first.
We were wondering whether to do both together. But the patient was advised conservative treatment- Physiotherapy elsewhere> Guys Magic still plays a role in medicine.
to answer sreenath, Axial cuts along the neck and trochanter superimposed on axial cuts at the epicondyle will give us the anterversion.
Anteversion first
ReplyDeletesir,how did you look into the anteversion value?
ReplyDeletesreenath