Isolated MPFL Reconstruction Stabilizes Patella Despite High Femoral Anteversion

Recurrent patellar dislocation represents a significant clinical challenge for the practicing orthopedist, often necessitating surgical intervention to prevent long-term joint degeneration and functional decline [1]. While the medial patellofemoral ligament is recognized as the primary soft tissue stabilizer against lateral patellar translation, isolated reconstruction is associated with a complication rate of approximately 26.1 percent [2]. In patients presenting with increased femoral anteversion (an inward twisting of the thigh bone that alters the pull of the quadriceps), surgeons frequently consider combining ligament reconstruction with a derotational distal femoral osteotomy to address the underlying bony malalignment [3, 4]. However, these derotational procedures involve significant surgical morbidity and potential risks, including peroneal nerve injury and hardware-related complications [5]. Although isolated reconstruction generally facilitates a high rate of return to athletic activity, the specific anatomical thresholds that mandate concomitant bony correction remain a subject of active clinical debate [6]. A recent study now offers data on whether isolated ligamentous stabilization is sufficient for patients with high femoral torsion but minimal maltracking.