Patellofemoral Instability: Diagnosis and Management

Patellofemoral articulation plays a major role in locomotion and other activities that involve knee flexion and extension. Problems of patellofemoral tracking are very common, ranging from mild lateral maltracking and tilt, to frank instability and dislocation of the patella. Patellofemoral instability can be defined as movement of the patella out of its normal position, and can be divided into dislocation and subluxation. Natural history of this condition is that of a relatively high recurrence. Even in the absence of recurrent instability, patients who sustain patella dislocation or subluxation may develop a number of significant problems, including persistent knee pain, functional limitations, decreased athletic performance, and arthritic degeneration of the patellofemoral articulation. Especially for the recurrent dislocator, surgical treatment plays an important role in management, since the natural history of this condition is that of relatively poor return to normal function.