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Four-Direction Procedures Involving Tibial Tubercle Osteotomy for Habitual Dislocation of the Patella: A Case Report
Patrick Yusin Yeh1, En-Rung Chiang2,3, Hsin-Yi Wang3,4
1Case Western Reserve University, Cleveland, Ohio.
Case:
A 22-year-old man with habitual dislocation of the patella (HDP), characterized by lateral dislocation in flexion with spontaneous relocation with extension, presented with right knee pain and inability to actively extend. Imaging revealed lateral patellar dislocation, flat articular surface of the patella, and trochlear dysplasia. His symptoms persisted despite physical therapy. A 4-directional patellar stabilization surgery, incorporating lateral release, medial tibial tuberosity osteotomy, quadriceps muscle lengthening, and medial patellofemoral ligament reconstruction, was performed, with significant improvement in pain and function postoperatively.
Conclusion:
The procedure could be feasible in cases of severe HDP when conservative measures failed to relieve the patient's symptoms.

