Abstract
Lateral patellar dislocation is a relatively common pathology that can be surgically treated with a medial patellofemoral ligament reconstruction. In rare occurrences patients can present with patellar maltracking that results in obligate patellar instability in flexion but central tracking in extension. This presentation can be much more complicated to treat surgically and may require a combination of multiple patellofemoral procedures. In this technique we describe a four-pronged treatment approach for improving patellar tracking in a patient with obligate flexion patellar dislocation and valgus malalignment including VY quadricepsplasty, distal femoral osteotomy, medial patellofemoral ligament reconstruction, and lateral retinacular and capsular reconstruction with a dermal allograft. © 2021