Management of patellofemoral instability: soft tissue procedures

Patellar instability refers to the abnormal displacement of the patella from the patellofemoral joint, which can range from subluxation to complete dislocation. This condition is often caused by multiple factors, including acute trauma, chronic ligament laxity, bony misalignment, connective tissue disorders, or anatomical abnormalities. The stability of the patella relies on a delicate balance of osteo-cartilaginous, ligamentous, and muscular elements. When these components are disrupted, it can lead to a range of issues, from anterior knee pain to recurrent dislocations. The surgical intervention aims to correct these anatomical irregularities. Key procedures include soft tissue techniques such as reefing, realignment, and reconstruction of the medial stabilizing structures, as well as the release of lateral structures. This article critically evaluates the effectiveness of these soft tissue techniques in managing patellofemoral instability, based on insights from extensive literature reviews and clinical studies.