(1) Orthopaedic Surgery Resident, Georgetown University Hospital, Washington, DC, USA
(2) Department of Orthopaedic Surgery, Sports Medicine, Georgetown University Hospital, Washington, DC, USA
* Corresponding author Email: firstname.lastname@example.org email@example.com
Patellar instability is most common among adolescent female athletes, although anyone can be affected. The aetiology of patellar instability is multifactorial and often the result of abnormal patellofemoral biomechanics and anatomy, as well as traumatic in origin. Diagnosis and management begin with physical examination and imaging such as radiographs, computed tomography or magnetic resonance imaging. The management of patellar instability is non-operative for primary dislocations, reserving operative management for patients with recurrent patellar instability. There are a variety of operative procedures including osseous realignment procedures as well as soft-tissue procedures aimed to correct predisposing factors contributing to patellar instability. The approach to patellar instability should be individualised and tailored to each patient’s symptoms, anatomy and physical demands to obtain the highest levels of success in this patient population. This article discusses patellar instability.
Patients with recurrent instability may benefit from operative management consisting of proximal or distal realignment procedures. Tailoring a patient’s treatment to symptoms, osseous morphology and specific injuries with patellar instability will lead to the best outcome and highest levels of satisfaction with this complex problem.