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Patellar Instability: Diagnostic Workup.

Zoe Hinton1, Kendall Bradley1, Jocelyn Wittstein1

  • 1Duke University Medical Center, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.

Video Journal of Sports Medicine
|March 9, 2026
PubMed
Summary
This summary is machine-generated.

A thorough physical examination is crucial for diagnosing patellofemoral instability. Understanding knee anatomy guides targeted assessments beyond standard evaluations for effective treatment.

Keywords:
patellapatellar instabilitypatellofemoralrecurrent instability

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Anatomy

Background:

  • The patella is integral to the knee's extensor mechanism, with its tracking influenced by static/dynamic restraints and bony anatomy.
  • Patellofemoral instability evaluation requires understanding nuanced tracking mechanisms throughout knee motion.

Purpose of the Study:

  • To outline a comprehensive physical examination protocol for diagnosing patellofemoral instability.
  • To emphasize the importance of anatomical knowledge in guiding diagnostic workup.

Main Methods:

  • Includes evaluation of femoral anteversion, tibial torsion, knee range of motion (J sign), patellar assessment (apprehension/translation), standing examination, and gait analysis.
  • Integrates anatomy-informed maneuvers with radiographic and cross-sectional imaging.

Main Results:

  • A complete examination assesses all parameters contributing to patellofemoral pathology.
  • This comprehensive approach aids in identifying causes of patellar maltracking.

Conclusions:

  • Anatomy-informed physical examination is vital for diagnosing patellofemoral instability.
  • This detailed assessment, combined with imaging, supports informed surgical decision-making.