Patient Story
Knee instability since age eight — back on the field after bilateral MPFL + TTO.
Years of physical therapy and braces couldn’t stop Avery’s frequent subluxations and full dislocations. The diagnosis: severe bilateral patellar misalignment with both kneecaps sitting more than ten millimeters out of place. Dr. Sabrina Strickland staged the repair across two years — bilateral MPFL reconstruction in 2018–2019, followed by bilateral tibial tubercle osteotomies and additional MPFL reconstructions in 2020.
Patient Story
From a defining lifelong challenge — to definitive correction.
Since age eight, knee instability has been a defining challenge for one young athlete. Despite years of physical therapy and knee braces, Avery continued to suffer from frequent subluxations and a full dislocation.
“Both kneecaps sitting more than ten millimeters out of place.” — Avery’s diagnosis
These issues were finally diagnosed as a severe case of patellar misalignment, with both kneecaps sitting more than ten millimeters out of place. Ultimately, she had a bilateral MPFL reconstruction in 2018–2019, followed by bilateral tibial tubercle osteotomies and additional MPFL reconstructions in 2020.
About Avery’s care path — staged bilateral correction
Severe patellar misalignment with bilateral involvement is one of the more anatomically challenging patellar instability presentations. Both kneecaps sitting more than 10mm out of correct position means the bony lever arm is fundamentally off, the medial soft-tissue restraints are insufficient, and standard physical therapy or bracing cannot restore the kneecaps to a stable track. The surgical answer combines two procedures, often staged across both knees over multiple operations.
MPFL reconstruction rebuilds the medial patellofemoral ligament — the primary medial soft-tissue restraint to lateral patellar translation — using a hamstring or quadriceps tendon graft. More on MPFL reconstruction surgery →
Tibial tubercle osteotomy (TTO) is a controlled cut and reposition of the bony attachment of the patellar tendon. When the underlying problem is bony — as in Avery’s severe misalignment — TTO corrects the lever arm so the MPFL reconstruction is protected from the same forces that destroyed the original anatomy. More on joint preservation & osteotomy →
For the broader patellar instability evaluation including the five anatomical risk factors that drive recurrent dislocation, see patellar instability.
Read more patient stories
Avery’s story is one of many. Hear from more of Dr. Strickland’s patients in their own words about how they got back to the lives they love.
