Patellar Instability

Patellar instability is a complex problem most often affecting adolescent females. Trochlear dysplasia is the most predictive of the anatomic factors leading to injury and recurrence, and others include patella alta, coronal plane malalignment such as genu valgum or extensor mechanism malalignment, excessive femoral anteversion, and other factors such as ligamentous laxity. First-time dislocations have historically been treated without surgery, but improved evidence defining high-risk groups has begun to drive an individually based approach. Patients with chondral/osteochondral injuries and recurrent injuries are candidates for surgical intervention, and treatment options are based on patient anatomy and risk for recurrence.