Abstract
Patellofemoral instability is a condition characterized by repeated dislocation or subluxation of the patella secondary to minimal trauma. This condition is known to be more common in females, and it is often bilateral. The reported incidence of patella dislocation in the population aged between 10 and 17 years old is reported at 29 per 100,000 [1]. After a first-time dislocation, the rate of recurrence following nonoperative treatment ranges between 15 and 44 % [2, 3].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004;32:1114–21.
Hawkins RJ, Bell RH, Anisette G. Acute patellar dislocations. The natural history. Am J Sports Med. 1986;14:117–20.
Cofield RH, Bryan RS. Acute dislocation of the patella: results of conservative treatment. J Trauma. 1977;17:526–31.
Andrish J. The biomechanics of patellofemoral stability. J Knee Surg. 2004;17:35–9.
Conlan T, Garth WP, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am. 1993;75:682–93.
Goodfellow J, Hungerford DS, Zindel M. Patello-femoral joint mechanics and pathology. 1. Functional anatomy of the patello-femoral joint. J Bone Joint Surg Br. 1976;58:287–90.
Aglietti P, Insall JN, Cerulli G. Patellar pain and incongruence. I: measurements of incongruence. Clin Orthop Relat Res. 1983;176:217–24.
Beighton PH, Horan F. Orthopedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg Br. 1969;51:444–53.
James SL. Running injuries to the knee. J Am Acad Orthop Surg. 1995;3:309–18.
Lee TQ, Yang BY, Sandusky MD, McMahon PJ. The effects of tibial rotation on the patellofemoral joint: assessment of the changes in situ strain in the peripatellar retinaculum and the patellofemoral contact pressures and areas. J Rehabil Res Dev. 2001;38:463–9.
Berg EE, Mason SL, Lucas MJ. Patellar height ratios. A comparison of four measurement methods. Am J Sports Med. 1996;24:218–21.
Dejour D, Le Coultre B. Osteotomies in patello-femoral instabilities. Sports Med Arthrosc. 2007;15:39–46.
Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am. 1974;56:1391–6.
Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc. 1994;2:19–26.
Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001;25:957–62.
Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc. 1998;30:556–69.
Stensdotter AK, Hodges PW, Mellor R, Sundelin G, Hager-Ross C. Quadriceps activation in closed and in open kinetic chain exercise. Med Sci Sports Exerc. 2003;35:2043–7.
Cowan SM, Bennell KL, Hodges PW. Therapeutic patellar taping changes the timing of vasti muscle activation in people with patellofemoral pain syndrome. Clin J Sport Med. 2002;12:339–47.
Nikku R, Nietosvaara Y, Kallio PE, Aalto K, Michelsson JE. Operative versus closed treatment of primary dislocation of the patella. Similar 2-year results in 125 randomized patients. Acta Orthop Scand. 1997;68:419–23.
Maenpaa H, Lehto MU. Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med. 1997;25:213–7.
McConnell J. Rehabilitation and nonoperative treatment of patellar instability. Sports Med Arthrosc. 2007;15:95–104.
Ahmad CS, Stein BE, Matuz D, Henry JH. Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. A review of eight cases. Am J Sports Med. 2000;28:804–10.
Farr J, Schepsis AA. Reconstruction of the medial patellofemoral ligament for recurrent patellar instability. J Knee Surg. 2006;19:307–16.
Steiner TM, Torga-Spak R, Teitge RA. Medial patellofemoral ligament reconstruction in patients with lateral patellar instability and trochlear dysplasia. Am J Sports Med. 2006;34:1254–61.
Donell ST, Joseph G, Hing CB, Marshall TJ. Modified Dejour trochleoplasty for severe dysplasia: operative technique and early clinical results. Knee. 2006;13:266–73.
Verdonk R, Jansegers E, Stuyts B. Trochleoplasty in dysplastic knee trochlea. Knee Surg Sports Traumatol Arthrosc. 2005;13:529–33.
Trillat A, Dejour H, Couette A. Diagnosis and treatment of recurrent dislocations of the patella. Rev Chir Orthop Reparatrice Appar Mot. 1964;50:813–24. French.
Fulkerson JP, Becker GJ, Meaney JA, Miranda M, Folcik MA. Anteromedial tibial tubercle transfer without bone graft. Am J Sports Med. 1990;18:490–7.
Barber FA, McGarry JE. Elmslie-Trillat procedure for the treatment of recurrent patellar instability. Arthroscopy. 2008;24:77–81.
Lattermann C, Toth J, Bach Jr BR. The role of lateral retinacular release in the treatment of patellar instability. Sports Med Arthrosc. 2007;15:57–60.
Colvin AC, West RV. Patellar instability. J Bone Joint Surg Am. 2008;90:2751–62.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 ISAKOS
About this chapter
Cite this chapter
Petrera, M., Dwyer, T., Gobbi, A. (2014). Patellofemoral Instability. In: Gobbi, A., Espregueira-Mendes, J., Nakamura, N. (eds) The Patellofemoral Joint. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54965-6_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-54965-6_10
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-54964-9
Online ISBN: 978-3-642-54965-6
eBook Packages: MedicineMedicine (R0)