This is the case of a 30 year old male who sustained an ACL reconstruction 13 years before with BPTB and lateral meniscectomy in his left knee. After a long period of good clinical results and sports activity he develop progressively anterior knee pain and patella hypermobility. No history of patellar instability.
At the clinical examination he had slight quadriceps hypotrophy, pain pushing the lateral facet of the patella, patellar hypermobility, "click" of the patella flexing the knee.
The MRI show patellar tilt and chondromalacie of the trochlear groove and lateral facet of the patella.
How would you treat this case?