Habitual Patellar Dislocation Treated By Anteromedial Tibial Tubercle Transfer (Fulkerson Osteotomy) with Medial Patellofemoral Ligament Reconstruction Using Superficial Layer of Quadriceps Tendon Autograft: A Case Report

Abstract

Introduction: Bony malalignment and soft tissue injury of Medial Patellofemoral Ligament (MPFL) in chronic patellar instability is considered as a surgical indication for distal realignment in the form of anteromedial tibial tubercle transfer (Fulkerson osteotomy) with MPFL reconstruction, are effectively unloads the lateral patella while making the patellofemoral joint more congruous, stable and pain free. Method: A 26 years old male with left habitual patellar dislocation and pain on his left knee. The patient underwent Fulkerson osteotomy (Tibial tuberosity elevation osteotomy and medial transfer) and medial patellofemoral ligament (MPFL) reconstruction using superficial layer of quadriceps tendon autograft. The patient underwent arthroscopic examination preoperatively and found cartilage lesion of patella (Outerbridge type III). Conclusion: Fulkerson osteotomy and MPFL reconstruction is a successful procedure to treat habitual patellar dislocation and patellofemoral pain. The Fulkerson osteotomy can improve the patella stability and knee function. MPFL reconstruction using superficial layer of quadriceps tendon was simple and has fewer complication than using other autografts, such as hamstring tendon, adductor tendon, and patellar tendon.