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Patellar Instability
Patellar instability
Mechanical alignment, including patellofemoral alignment with bone and soft tissue structures, allows normal patellar tracking.
Patellar Femoral joint
Soft tissue
Axial view of knee. MPFL: medial patellofemoral ligament.
Factors affecting patella tracking
Effect of knee alignment on PFJ tracking
Valgus knee: ↑ Q angle
Mechanism of Patellar Dislocation
Patellar dislocation
Management approach to Patellar instabilty
Surgery:
Arthroscopy of the knee joint
and Medial Patellar Femoral Ligament (MPFL) reconstruction
Medial Patellar Femoral Ligament (MPFL) reconstruction
Graft
- Allograft
- Autograft
Fixation options
- Screw fixation
- Endobutton
- Anchor/s
MPFL reconstruction
Post Patellar MPFL Reconstruction
Knee bracing with prescription
Progressive knee range of motion under professional supervision
Download ASSIC Performance Fingerprint and Strength & Conditioning apps for guideline on post MPFL reconstruction under your professional supervision
References
- Barnett AJ, Howells NR, Burston BJ, Ansari A, Clark D, Elridge JD: Radiographic landmarks for tunnel placement in reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 2012; 20(12)2380-2384.
- Stephen JM, Lumpaopong P, deehan DJ, Kader D, Amis AA: The medial patellofemoral ligament: Location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med 2012; 40(8): 1871-1879.
- Schöttle PB, Schmeling A, Rosenstiel N, Weiler A: Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament recondtruction. Am J Sports Med 2007; 35(5): 801-804.
- Bollier M, Fulkerson J.P.The Role of Trochlear Dysplasia in Patellofemoral Instability. J Am Acad Orthop Surg 2011;19: 8-16.
