Adductor tenotomy provides good symptomatic and functional improvement in chronic adductor-related groin pain refractory to conservative treatment.

Tibial tubercle advancement osteotomy can be an effective treatment for anterior knee pain and for patients with arthroscopic evidence of patellar chondral damage. It can provide excellent/good long-term functional results in the majority of patients, with very high satisfaction levels and sustained improvement in pain symptoms. The use of femoral head bone allograft is both effective in obtaining bony union and by definition avoids the donor-site morbidity. Knees with patellar malalignment may also undergo individualised medialisation of the tibial tubercle such that the patella lies in the centre of the femoral trochlea, and may benefit from lateral trochleaplasty surgery in the presence of trochlear dysplasia. However, the major operative complication rate is high at 12%, and fracture of the tibial tubercle is associated with a poorer outcome. One can expect 10% of operated knees to have had some clinical deterioration in the patellofemoral joint by a mean follow-up of 93 months.

Transient laxity in association with pregnancy of the native anterior cruciate ligament has been previously documented. This phenomenon has only been previously reported in one case of ACL reconstruction, but it has been recommended that patients that become pregnant soon after surgery should be closely observed. We report three cases of pregnancy in relation to primary ACL reconstruction with no obvious adverse outcomes observed on objective assessments. We also report one case of revision ACL reconstruction during pregnancy with a good clinical outcome. We suggest that any hormonal effects on ACL reconstruction during pregnancy, if they do occur, are likely to be very transient and of doubtful clinical impact. In addition, we feel that pregnancy should not be regarded as an orthopaedic contraindication to ACL reconstruction surgery.