Arthroscopic and Mini‐Open Combined Medial Patellofemoral Ligament and Medial Patellotibial Ligament Reconstruction for J‐Sign‐Positive Patellar Dislocation

Abstract This technical note addresses recurrent patellar instability with a positive J‐sign and describes a minimally invasive, arthroscopic and mini‐open approach that combines medial patellofemoral ligament and medial patellotibial ligament reconstruction with extensive lateral retinacular release, positioned as a preferred or transitional option before bony procedures. The strategy emphasizes functional localization and tension modulation. Compared with imaging threshold‐driven osteotomies, this approach is less invasive, cosmetically favorable, individually adjustable, and supports rapid rehabilitation. It can serve as definitive treatment for skeletally immature patients or those with low‐grade J‐sign, and for high‐grade J‐sign it may reduce reliance on osteotomy while preserving a clear pathway for salvage if needed.