Feature Question

(OBQ11-34) An 18-year-old female has 9 months of anterior knee pain recalcitrant to physical therapy that includes VMO strengthening, NSAIDS, and lifestyle modification. On physical examination she has no effusion in the knee and her Q angle is measured at 15 degrees. She has less than one quadrant of medial patella translation and less than two quadrants of lateral patella translation. The lateral edge of the patella is unable to be everted. A merchant view radiograph is shown in Figure A. The tibia tubercle-trochlear groove distance is measured as 14mm on a CT scan. Which of the following procedures is MOST appropriate? REVIEW TOPIC
FIGURES: A          

1. Lateral retinacular release
2. Anterolateral tibial tubercle osteotomy
3. Anterior tibial tubercle osteotomy (Maquet)
4. Medial tibial tubercle osteotomy (Elmslie-Trillat)
5. Medial plica resection