Stepwise Lengthening of the Quadriceps Extensor Mechanism for Severe Obligatory and Fixed Patella Dislocators

Abstract

We introduce an algorithm of independently performing vastus lateralis lengthening followed by Z lengthening of the rectus and intermedius portion of the quadriceps tendon to treat fixed and obligatory patellar instability in the pediatric population. Performing this procedure in conjunction with medial patellofemoral ligament reconstruction minimizes subsequent episodes of instability without creating extensor mechanism weakness or contracture.