Skip to main content

Patellar Instability

  • Chapter
  • First Online:
Atlas of Knee Arthroscopy

Abstract

The symptomatic patello-femoral compartment can have a broad spectrum of causes and presentations. Anterior knee pain can be present without apparent pathological clinical findings. The etiology is ill-defined and patellar maltracking alone cannot explain all clinical presentations, especially the pain at rest. A history of trauma may lead to recurrent dislocations and instability if additional anatomical morphological abnormalities are present. Thus, numerous factors have to be evaluated in order to improve the accuracy of determining the cause of the symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Warren LA, Marshall JL, Girgis F. The prime static stabilizer of the medical side of the knee. J Bone Joint Surg Am. 1974;56(4):665–74.

    CAS  PubMed  Google Scholar 

  2. Desio SM, Burks RT, Bachus KN. Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med. 1998;26(1):59–65.

    CAS  PubMed  Google Scholar 

  3. Senavongse W, Amis AA. The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability: a biomechanical study in vitro. J Bone Joint Surg Br. 2005;87(4):577–82.

    Article  CAS  PubMed  Google Scholar 

  4. Insall J, Salvati E. Patella position in the normal knee joint. Radiology. 1971;101(1):101–4.

    Article  CAS  PubMed  Google Scholar 

  5. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg Br. 1977;59(2):241–2.

    CAS  PubMed  Google Scholar 

  6. Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H. Patella infera. Apropos of 128 cases. Rev Chir Orthop Reparatrice Appar Mot. 1982;68(5):317–25.

    CAS  PubMed  Google Scholar 

  7. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc. 1994;2(1):19–26.

    Article  CAS  PubMed  Google Scholar 

  8. Lippacher S, Dejour D, Elsharkawi M, Dornacher D, Ring C, Dreyhaupt J, Reichel H, Nelitz M. Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images. Am J Sports Med. 2012;40(4):837–43.

    Article  PubMed  Google Scholar 

  9. Merchant AC. Classification of patellofemoral disorders. Arthroscopy. 1988;4(4):235–40.

    Article  CAS  PubMed  Google Scholar 

  10. Eckhoff DG, Montgomery WK, Kilcoyne RF, Stamm ER. Femoral morphometry and anterior knee pain. Clin Orthop Relat Res. 1994;302:64–8.

    PubMed  Google Scholar 

  11. Dejour D, Saggin PR, Meyer X, Tavernier T. Standard X-ray examination: patellofemoral disorders. In: Zaffagnini S et al., editors. Patellofemoral pain, instability, and arthritis. Heidelberg/New York: Springer; 2010.

    Google Scholar 

  12. Christoforakis J, Bull AM, Strachan RK, Shymkiw R, Senavongse W, Amis AA. Effects of lateral retinacular release on the lateral stability of the patella. Knee Surg Sports Traumatol Arthrosc. 2006;14(3):273–7.

    Article  CAS  PubMed  Google Scholar 

  13. LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007;89(9):2000–10.

    Article  PubMed  Google Scholar 

  14. Muneta T, Sekiya I, Tsuchiya M, Shinomiya K. A technique for reconstruction of the medial patellofemoral ligament. Clin Orthop Relat Res. 1999;359:151–5.

    Article  PubMed  Google Scholar 

  15. Schöttle PB, Fucentese SF, Romero J. Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability. Knee Surg Sports Traumatol Arthrosc. 2005;13(7):516–21.

    Article  PubMed  Google Scholar 

  16. Matsushita T, Kuroda R, Oka S, Matsumoto T, Takayama K, Kurosaka M. Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance. Knee Surg Sports Traumatol Arthrosc. 2014. [Epub ahead of print].

    Google Scholar 

  17. Vavken P, Wimmer MD, Camathias C, Quidde J, Valderrabano V, Pagenstert G. Treating patella instability in skeletally immature patients. Arthroscopy. 2013;29(8):1410–22.

    Article  PubMed  Google Scholar 

  18. Magnussen RA, De Simone V, Lustig S, Neyret P, Flanigan DC. Treatment of patella alta in patients with episodic patellar dislocation: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2013. doi: 10.1007/s00167-013-2445-8

  19. Siebold R, Sartory N. Arthroscopic medial reefing in acute patellar dislocation. In: Zaffagnini S et al., editors. Patellofemoral pain, instability, and arthritis. Heidelberg/New York: Springer; 2010.

    Google Scholar 

  20. Schöttle PB, Schmeling A, Rosenstiel N, Weiler A. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med. 2007;35(5):801–4.

    Article  PubMed  Google Scholar 

  21. Marcacci M, Zaffagnini S, Lo Presti M, Vascellari A, Iacono F, Russo A. Treatment of chronic patellar dislocation with a modified Elmslie-Trillat procedure. Arch Orthop Trauma Surg. 2004;124(4):250–7.

    Article  CAS  PubMed  Google Scholar 

  22. Carney JR, Mologne TS, Muldoon M, Cox JS. Long-term evaluation of the Roux-Elmslie-Trillat procedure for patellar instability: a 26-year follow-up. Am J Sports Med. 2005;33(8):1220–3.

    Article  PubMed  Google Scholar 

  23. Fulkerson JP. Anteromedialization of the tibial tuberosity for patellofemoral malalignment. Clin Orthop Relat Res. 1983;(177):176–81.

    Google Scholar 

  24. Dejour D, Byn P, Saggin PR. Deepening trochleoplasty for patellar instability. In: Zaffagnini S et al., editors. Patellofemoral pain, instability, and arthritis. Heidelberg/New York: Springer; 2010.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Horia Haragus MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Ramadani, F., Haragus, H. (2015). Patellar Instability. In: Prejbeanu, R. (eds) Atlas of Knee Arthroscopy. Springer, London. https://doi.org/10.1007/978-1-4471-6593-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6593-4_8

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6592-7

  • Online ISBN: 978-1-4471-6593-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics