Table 1.

Advantages and Disadvantages

Advantages	Disadvantages
An anatomic reconstruction is performed that best approximates native anatomy	Intraoperative fluoroscopy is required
Does not violate distal femoral physis or articular surface	Creation of patellar bone tunnels carries a low risk of patellar fracture
Allograft choice allows for preservation of native tendon and avoidance of donor site morbidity	Lateral lengthening calls for additional dissection compared with MPFL reconstruction alone
Open lateral lengthening allows for measured improvement in lateral sided tension compared to arthroscopic alternatives	The adjustable loop button can be overtightened, which would require button removal and attaching a new adjustable loop cortical button
The laterally based parapatellar incision allows for easy visualization and manipulation of the cortical button
Single-incision technique for lateral lengthening and MPFL reconstruction
The cortical button does not run the risk of graft damage or screw loosening and migration