Wiki Need help with proximal and distal patellar realignment with tibial tuberosity osteotomy and MPFL repair.

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The tibial turburcle is cut and moved which shifts the lower ligament. The MPFL also plays a critical part in keeping the patella in alignment, so frequently the MPFL is worked on as well. If the MPFL is being worked on solely to help with the patella alignment, I would include it in the TTO. However, if the MPFL is detached, stretched or otherwise compromised I would bill for it separately. I hope this helps. ** Could you redact and post the op note? The patellar ligament is distal to the patella. The quads attach proximally. I have never heard of a patellar realignment that included any work to proximal to the patella.
 
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