This video, titled "Patella Matrix-induced Autologous Chondrocyte Implantation (MACI) with Tibial Tubercle Osteotomy, Lateral Lengthening, and MPFL Reconstruction," provides an overview of evaluating and treating patellar cartilage defects in the context of patellar instability and malalignment. Viewers will learn how to assess patients with patellar dislocation and associated osteochondral defects, we will discuss surgical treatment options and explain the thought process that went into our decision making with a case example. The video will provide step-by-step insight into the combined procedure, including diagnostic arthroscopy and chondrocyte harvest for patellar MACI, tibial tubercle osteotomy, lateral lengthening, and MPFL reconstruction. The video will conclude with the post-operative course and outcomes that have been published in the literature.