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Patellofemoral Instability: Distal Realignment

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Book cover Disorders of the Patellofemoral Joint

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Abstract

Distal realignment is one of the most well-established treatments for patellar instability, allowing treatment of risk factors including patella alta and increased tibial tubercle-trochlear groove (TT-TG) distance. Prior to performing a distal realignment, the surgeon needs to perform a comprehensive assessment of the patient including measurement of patellar height and alignment. Distal realignment is best employed if either of these is abnormal—if trochlear dysplasia or rotational abnormalities of the limb are present, other surgical interventions may be more appropriate. This chapter outlines the rationale for distal realignment, the regime of preoperative assessment and the surgical technique. Performed properly, for the correct indications, and in the absence of complications including fracture, iatrogenic patella baja and nonunion, distal realignment can achieve excellent results, with a long-term rate of recurrent instability of around 7% overall.

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Author information

Authors and Affiliations

  1. Department of Trauma and Orthopaedics, University College London Hospitals NHS Trust, London, UK

    Suroosh Madhanipour

  2. Senior Knee Fellow, University College London Hospitals NHS Trust, London, UK

    Kostas Michail

  3. Department of Orthopaedic Surgeon, University College London Hospitals NHS Trust, London, UK

    Sam Oussedik

Authors
  1. Suroosh Madhanipour
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  2. Kostas Michail
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  3. Sam Oussedik
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Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. University College London Institute of Orthopaedics, London, UK

    Alexander D. Liddle

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Madhanipour, S., Michail, K., Oussedik, S. (2019). Patellofemoral Instability: Distal Realignment. In: Rodríguez-Merchán, E., Liddle, A. (eds) Disorders of the Patellofemoral Joint. Springer, Cham. https://doi.org/10.1007/978-3-030-12442-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-12442-7_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12441-0

  • Online ISBN: 978-3-030-12442-7

  • eBook Packages: MedicineMedicine (R0)

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