Review Question - QID 217982

A 20-year-old female soccer player presents to your clinic with complaints of repeated patellar dislocations. She reports these episodes primarily occur during non-contact, twisting episodes while playing soccer. She denies any mechanical symptoms at this time but is having recurrent effusions. She has failed physical therapy. An MRI is obtained which demonstrates an MPFL rupture, TT-TG distance of 20mm, Insall-Salvati ratio = 1.15 and no signs of trochlear dysplasia. You discuss operative management with the patient and recommend MPFL reconstruction and Fulkerson osteotomy. If this procedure were performed, patellofemoral contact pressures would be most increased in which quadrants?