Specific considerations in female patients with patellar instability: current concepts

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Patellofemoral instability (PFI) demonstrates higher prevalence in female populations.
• Anatomical sex differences, including trochlear dysplasia, patella alta, increased Q angle, and soft tissue imbalances, contribute to PFI in women.
• Worse outcomes are reported in female patients post-patellofemoral stabilization surgery.

Purpose of the Study:

• To investigate the anatomical factors contributing to patellofemoral instability (PFI) in female patients.
• To evaluate the efficacy of current surgical interventions for PFI in women.
• To propose an individualized treatment approach for female patients with PFI.

Main Methods:

• Review of existing literature on patellofemoral instability prevalence and contributing factors in males versus females.
• Analysis of surgical outcomes for patellofemoral stabilization procedures (MPFLr, TTO) in female patients.
• Exploration of anatomical risk factors and their correlation with surgical success.

Main Results:

• Significant anatomical differences exist between sexes, predisposing women to PFI.
• Current surgical strategies, including MPFLr and TTO, show suboptimal outcomes in female patients.
• Anatomical variations necessitate tailored surgical planning.

Conclusions:

• Female patients exhibit unique anatomical predispositions to patellofemoral instability.
• A standardized surgical approach may not be optimal for all female patients.
• An individualized, "à la carte" treatment strategy addressing specific anatomical risk factors is recommended for improved outcomes in female PFI patients.