Modern management of patellar instability.
Recurrent patellofemoral instability is a disabling condition, attributed to a variety of anatomical aetiologies. Trochlear dysplasia, patella alta, an increased tibial tubercle trochlear groove distance of greater than 20 mm and soft tissue abnormalities such as a torn medial patellofemoral ligament and inadequate vastus medialis obliquus are all factors to be considered. Management of this condition remains difficult and controversial and knowledge of the functional anatomy and biomechanics of the patellofemoral joint, a detailed history and clinical examination, and an accurate patient assessment are all imperative to formulate an appropriate management plan. Surgical treatment is based on the underlying anatomical pathology with an aim to restore normal patellofemoral kinematics. We summarise aspects of assessment, treatment and outcome of patellofemoral instability and propose an algorithm of treatment.
The Robert Jones and Agnes Hunt Orthopaedic Hospital Oswestry, Oswestry, Shropshire, UK.
Shin-Jae
SJ
Rhee
George
G
Pavlou
Jeremy
J
Oakley
David
D
Barlow
Farres
F
Haddad
D000465:Algorithms; D001696:Biomechanical Phenomena; D019468:Disease Management; D006801:Humans; D007593:Joint Instability / Q000628:therapy*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D010027:Osteotomy; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016896:Treatment Outcome