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Patellar Instability

Categories
  • Joint/Tendon
  • Knee
Tags
  • knee injury
Knee Anatomy & Examination

Patellar instability

Mechanical axis​
Mechanical axis​
Muscle and tendon attachments

Mechanical alignment, including patellofemoral alignment with bone and soft tissue structures, allows normal patellar tracking​.

Patellar Femoral joint
Soft tissue

Patellar Femoral joint_Soft tissue
Axial view of knee

Axial view of knee. MPFL: medial patellofemoral ligament.​

Factors affecting patella tracking

Q-Angle
Factors affecting patella tracking
Patella height

Effect of knee alignment on PFJ tracking

Valgus knee: ↑ Q angle​

Valgus Knee

Mechanism of Patellar Dislocation

Mechanism of patellar dislocation

Patellar dislocation​

Patellar dislocation​

Management approach to Patellar instabilty

Management approach to Patellar instabilty

Surgery:
Arthroscopy of the knee joint
and Medial Patellar Femoral Ligament (MPFL) reconstruction

Arthroscopy of the knee joint

Medial Patellar Femoral Ligament (MPFL) reconstruction

Graft
  • Allograft
  • Autograft
Graft
Fixation options
  • Screw fixation
  • Endobutton
  • Anchor/s
MPFL reconstruction
MPFL reconstruction

Post Patellar MPFL Reconstruction

Knee bracing with prescription
Knee bracing with prescription
Progressive knee range of motion
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

apple app store  google play store

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.

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