Anteromedialization as originally described by Fulkerson has become an important tool in the armamentarium of patellofemoral surgeons. The goal is to combine the unloading of tibial tubercle anteriorization and the realignment of tubercle medialization. The classic teaching, that the steepest slope of 60° allows approximately 9 mm of medialization with 15 mm of unloading anteriorization, is now challenged, and we may not be achieving the amount of anteriorization as preoperatively planned. Because failure to unload the patellofemoral compartment may adequately compromise surgical outcomes, thorough re-evaluation of anteromedialization measurement is warranted.
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