Unusual Case of Recurrent Patellar Instability with Genu Valgum Treated in a Single-stage Oblique-plane Proximal Tibial Osteotomy, Medial Patellofemoral Ligament Reconstruction, and Patellar Osteochondral Fracture Open Reduction and Internal Fixation

An adolescent patient presented with left patellofemoral instability with a patella osteochondral fracture in the setting of genu valgum and an elevated tibial tubercle to trochlear groove (TT-TG) distance. The patient underwent left medial patellofemoral ligament reconstruction and patellar osteochondral fracture open reduction and internal fixation with a concomitant oblique-plane proximal tibial osteotomy with frame osteosynthesis to achieve varus-producing correction and tibial tubercle anteromedialization. The patient experienced full recovery with complete healing of the osteochondral fracture, stabilization of the patellofemoral joint, and restoration of anatomic coronal and axial plane alignment. She reported significant improvements in mobility and pain. This case report highlights the novelty of this combined procedure in adequately addressing recurrent patellar instability in the setting of multiplanar deformity, uniquely utilizing a single oblique cut osteotomy with frame correction to correct valgus tibial deformity and elevated TT-TG.