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Modern management of patellar instability.
[trochlear dysplasia]
Recurrent
patellofemoral
instability
is
a
disabling
condition
,
attributed
to
a
variety
of
anatomical
aetiologies
.
Trochlear
dysplasia
,
patella
alta
,
an
increased
tibial
tubercle
trochlear
groove
distance
of
greater
than
20
Â
mm
and
soft
tissue
abnormalities
such
as
a
torn
medial
patellofemoral
ligament
and
inadequate
vastus
medialis
obliquus
are
all
factors
to
be
considered
.
Management
of
this
condition
remains
difficult
and
controversial
and
knowledge
of
the
functional
anatomy
and
biomechanics
of
the
patellofemoral
joint
,
a
detailed
history
and
clinical
examination
,
and
an
accurate
patient
assessment
are
all
imperative
to
formulate
an
appropriate
management
plan
.
Surgical
treatment
is
based
on
the
underlying
anatomical
pathology
with
an
aim
to
restore
normal
patellofemoral
kinematics
.
We
summarise
aspects
of
assessment
,
treatment
and
outcome
of
patellofemoral
instability
and
propose
an
algorithm
of
treatment
.
