Multiple kneecap dislocations. two failed lateral release 8 months. trochler groove pretty straight across. arthritis . tkr vs mpfl?

Depends: Unusual for patellar dislocations to continue at your age. Nonetheless, if there is arthritis under the kneecap and the rest of the knee , total knee replacement would be the way to go. Mpfl recon can be considered with imbrication vs. Allografting if tissue is too stretched.

Let me explain: It depends on how much arthritis you have in the knee, if the joint really have a lot of arthritis i would advise tkr. If the changes are not much you have the reconstruction for know and possibly the tkr if needed when are more older . Good luck.