Table 3.

Pearls and Pitfalls

Pearls 1. Ensure balanced tracking of the patella in the femoral trochlea first using lateral release and tibial tubercle transfer selectively. 2. Once the tibial tubercle is fixed in the corrected position, the lateral release is repaired by rotating a flap of tissue from the adjacent iliotibial band to close the defect. This prevents development of lateral side laxity. 3. Ensure a long enough incision with adequate skin flaps to palpate appropriate femoral landmarks.

Pitfalls 1. Failure to correct underlying malalignment. 2. Failure to accurately identify the lateral patellofemoral ligament femoral attachment site. 3. Overtensioning the graft.