Podium Presentation Title: Outcomes for Medial Patellofemoral Ligament Reconstruction with Concomitant Tibial Tubercle Osteotomy for Failed Patellar Stabilization versus Primary Medial Patellofemoral Ligament Reconstruction with Concomitant Tibial Tubercle Osteotomy

It is not currently understood which subset of patients with recurrent patellofemoral instability require concomitant bony realignment procedures in addition to a soft tissue stabilization. Additionally, the optimal timing surgical intervention well defined by current literature and can be dictated skeletal maturity patient. If patient’s complete pathology addressed at their primary procedure, there high risk necessitating revision surgery. known if outcomes medial reconstruction tibial tubercle osteotomy (MPFL+TTO) performed as procedure equate MPFL+TTO setting. This study compares who underwent versus those same Patients from March 2014 December 2018 were identified an institutional registry. separated into two groups, undergoing after previously failed attempt for patellar Baseline demographic, radiographic, knee-specific patient reported outcome measures (PROMs) including KOOS QOL, Pedi-Fabs, IKDC, KOOS-PS, Kujala collected prior surgery 1- 2-years following intervention. Return sport (RTS) rates events also collected. Radiographic measurements included Caton-Dechamps Index (CDI), Patellar Trochlear (PTI)1, Tibial Tubercle-Trochlear Groove (TT-TG), Tubercle-Lateral Ridge (TT-LTR)2, Tendon-Lateral (PT-LTR)3 Depth (TDI). 92 knees (84 patients) included; 59 group 33 group. No differences between groups respect sex (85% vs. 82%, p=0.715), age (23.7 22.5, p=0.468), BMI (26.3 vs 24.5, p=0.144), TT-TG (20.3 19.3, p=0.238), or patella alta (33% 19%, p=0.354). Previous cohort 12 MPFL reconstructions, 3 transfers, 16 lateral releases, 9 imbrications/reefings/plications, 7 loose body removals chondroplasties. 53 (90%) 29 (88%) had minimum 2-year follow-up. There was no difference dislocation (4% 0%, p=0.547), subluxation (9% p=0.162) RTS (88% 83%, p=0.713). In regard RTS, 79% 71% returned equal higher level (p=0.461). At baseline, IKDC (42.0 34.7, p=0.049). follow-up both significant improvements baseline all PROMs, except Pedi-FABS change. KOOS-QoL (60.8 51.1, p=0.186), (8.0 7.3, p=0.796), (75.2 67.7, p=0.206), KOOS-PS (15.8 20.9, p=0.379), (86.5 77.9, p=0.143). The mean TT-TG, CDI, PTI presence similar groups. dysplasia, TDI < mm, present 77% measure extensor mechanism containment, TT-LTR, rate TT-LTR within 1 found predictive instability, 18% 26% PT-LTR, measurement tracking, statistically significantly (11.9 8.7, p=0.045). Management complex. whether indicated has yet elucidated. demonstrates that have comparable objective subjective short term Ongoing data collection this will determine these results are sustained long