Lateral Patellar Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Patellar instability is a common condition with complex causes.
• Patient-specific factors like patella alta and increased TT-TG distance influence recurrence risk.
• Cartilage lesions and fractures are frequent in first-time dislocations, necessitating advanced imaging.

Purpose of the Study:

• To review current understanding and treatment strategies for patellar instability.
• To highlight the role of anatomical factor identification in tailoring treatment.
• To discuss various surgical interventions and their indications.

Main Methods:

• Review of current literature on patellar instability.
• Analysis of predisposing anatomical factors.
• Evaluation of surgical techniques including MPFL reconstruction, tibial tubercle osteotomy, and trochleoplasty.

Main Results:

• Medial patellofemoral ligament (MPFL) reconstruction shows lower recurrence rates than repair.
• Tibial tubercle osteotomy is effective for increased TT-TG distance and patella alta.
• Combined femoral derotational osteotomy and MPFL reconstruction benefit patients with significant femoral anteversion.

Conclusions:

• Personalized treatment based on anatomical assessment is crucial for managing patellar instability.
• MPFL reconstruction and tibial tubercle osteotomy are valuable surgical options.
• Emerging techniques like trochleoplasty address severe dysplasia, with ongoing research into indications and outcomes.