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Patellofemoral Instability: Evaluation and Management.

Boden1, Pearsall, Garrett

  • 1Department of Orthopaedics, Duke University Medical Center, Durham, NC, at the time of this writing.

The Journal of the American Academy of Orthopaedic Surgeons
|January 1, 1997
PubMed
Summary

Patellofemoral disorders, a common cause of knee pain, are diagnosed through history, physical exam, and imaging. Treatment ranges from nonoperative care to surgical interventions like lateral release or realignment procedures.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Patellofemoral disorders are prevalent causes of knee pain and functional limitation.
  • Accurate diagnosis relies on comprehensive patient history, physical examination, and advanced imaging.
  • Magnetic resonance imaging (MRI) is crucial for assessing malalignment and soft-tissue injuries.

Purpose of the Study:

  • To categorize patellofemoral disorders and outline diagnostic and therapeutic strategies.
  • To review current understanding of patellofemoral disorder classification and management.
  • To highlight the role of imaging and surgical interventions in treating these conditions.

Main Methods:

  • Systematic review of diagnostic and treatment modalities for patellofemoral disorders.

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  • Analysis of imaging techniques, particularly MRI, for evaluating knee anatomy and pathology.
  • Categorization of disorders into soft-tissue abnormalities, instability, and arthritis.

    • Main Results:

    • Patellofemoral disorders are broadly classified into soft-tissue abnormalities, instability (subluxation/dislocation), and arthritis.
    • Nonoperative management is effective for many cases.
    • Surgical options include lateral release for tilt, anteromedial tibial tubercle transfer for malalignment, and MPFL repair for instability.

    Conclusions:

    • Effective management of patellofemoral disorders requires accurate diagnosis and tailored treatment plans.
    • Surgical interventions can significantly improve outcomes for specific conditions like instability and malalignment.
    • While patellofemoral arthritis lacks a definitive cure, symptom management through arthroscopic procedures is possible.