Patellar Instability

Introduction

Acute traumatic

  • Direct blow to the knee.
  • Evenly prevalence by gender.

Chronic

  • Anatomical malalignment
  • Ligamentous laxity

Habitual

Epidemiology

  • 5.8 per 100,000 persons
  • Occurs 10-20 years

Pathophysiology

Classification

Dejour

Clinical Evaluation

Investigations

X-Ray

  • True lateral (30 degrees knee flexion)
  • Frontal
  • Sunrise / Merchant view (45 degrees knee flexion)

Image interpretation

Management

Surgical management

MPFL reconstruction

TTT

Trochlearplasty

Videos

David Dejour – EFORT 2019

https://efortnet.conference2web.com/#!resources/tbd-d9c10653-2a0f-4b43-a962-4268106912e6

Philippe Tscholl – EFORT 2018

The Relevance Of Femoral Tunnel Positioning In Medial Patellofemoral Ligament Reconstruction On Postoperative Outcome

https://efortnet.conference2web.com/#!resources/the-relevance-of-femoral-tunnel-positioning-in-medial-patellofemoral-ligament-reconstruction-on-postoperative-outcome

Philip Schoettle – MPFL Reconstruction

Philip Schoettle – Trochlearplasty

References

Diduch, David R. MD; Kandil, Abdurrahman MD; Burrus, M. Tyrrell MD Lateral Patellar Instability in the Skeletally Mature Patient: Evaluation and Surgical Management, Journal of the American Academy of Orthopaedic Surgeons: June 15, 2018 – Volume 26 – Issue 12 – p 429-439 doi: 10.5435/JAAOS-D-16-00052

Thompson, Peter and Metcalfe, Andrew. Current concepts in the surgical management of patellar instability. The Knee November 11, 2019. Volume 26 (2019) p1171 – 1181. https://doi.org/10.1016/j.knee.2019.11.007