Reconstruction of the medial patellofemoral ligament for painful patellar subluxation in distal torsional malalignment: a case report

Complex two-level rotational malalignment of the lower extremity can cause maltracking of the patella with anterior knee pain. Double derotation osteotomy would correct the underlying pathology. However, it carries a high risk of complications such as nerve and vessel damage. We report a case of rotational malalignment in the femur and the tibia associated with trochlear dysplasia, which causes painful patellar instability. The patient was successfully treated with reconstruction of the medial patellofemoral ligament and lateral release. Although the malrotation was not addressed, the position of the patella was corrected, and no dislocation occurred during a follow-up of 10 months.