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Guidelines for medial patellofemoral ligament reconstruction in chronic lateral patellar instability.
[trochlear dysplasia]
The
standard
surgical
approach
for
chronic
lateral
patellar
instability
with
at
least
two
documented
patellar
dislocations
is
to
stabilize
the
patella
by
using
an
anatomic
medial
patellofemoral
ligament
reconstruction
with
a
mini-
open
technique
and
a
graft
that
is
stronger
than
the
native
ligament
to
compensate
for
the
uncorrected
predisposing
factors
underlying
patellar
instability
.
Even
though
medial
patellofemoral
ligament
reconstruction
has
evolved
notably
during
the
past
two
decades
,
many
aspects
of
the
surgical
technique
need
to
be
refined
,
and
more
information
is
needed
toward
this
end
.
Adequate
positioning
of
the
graft
on
the
femur
,
as
well
as
inducing
the
appropriate
degree
of
tension
,
are
critical
steps
for
the
overall
outcome
of
medial
patellofemoral
ligament
reconstruction
.
Moreover
,
it
is
necessary
in
some
cases
to
pair
medial
patellofemoral
ligament
reconstruction
with
other
surgical
procedures
to
address
additional
patellar
instability
risk
factors
,
such
as
trochlear
dysplasia
,
malalignment
,
and
patella
alta
.