Kinetic and Kinematic Analysis of Iatrogenic Medial Patellar Instability: Clinical Relevance

Abstract

We speculate that chronic recurrent soft tissue fatigue or overload due to patellofemoral imbalance could cause anterior knee pain. However, many chondropathies can be asymptomatic due to the biomechanic defence strategies used by the patients. Moreover, we emphasize the importance of the passive restraining structures in patellar stability, in contrast to the role of muscle function advocated by some authors. This could explain why an exercise rehabilitation program could be unsuccessful in improving patellar instability, as it occurred in our cases. Finally, these cases highlight the need for surgeons to be more judicious in their surgical selection for patellofemoral instability and serve as a warning for the generalized use of lateral retinacular release. The question we ask ourselves is: Is there a place for the isolated lateral retinacular release? In this sense, it would be interesting to consider the lengthening of the lateral retinaculum described by Roland Biedert as an alternative to lateral retinacular release.