Patellofemoral Joint Instability: A Review of Current Concepts

Abstract

The patellofemoral joint remains the enigma of orthopedics and sports medicine. Patellar dislocation is a common problem in the younger and athletic population and it is more disabling than cruciate ligament injuries. The pathology is often multifactorial and complex with no one factor being the sole defining etiology. The current management of patella dislocation has been linked with poor patient satisfaction possibly due to a prolonged period of conservative treatment and the general tendency to delay surgical intervention. This review will address the main abnormal anatomical factors contributing to patellar instability, their clinical and radiological diagnoses, and the role of various surgical interventions, including the medial patellofemoral ligament reconstruction in stabilizing the patella.

Etiopathogenic bases for patellofemoral arthritis development

“…Кроме того, существуют так называемые «спящие» суставные фасетки (семь штук), которые взаимодействуют с медиальным мыщелком бедра при сгибании в КС свыше 90° [29, 30,31]. Подобное сложное строение суставных поверхностей и непостоянное их взаимодействие приводят к нарушению рас-пределения сил напряжения в КС при пато-логии оси нижней конечности.…”

Tradução e adaptação transcultural para a língua portuguesa do Questionário Banff para Instabilidade Patelar

“…7,8 Sendo uma condição multifatorial, 1-9 a instabilidade patelar pode ser manejada com diversas opções terapêuticas, a depender das características anatômicas do paciente e do quadro individualizado. 10 Ao se utilizar apenas critérios clínicos e radiográficos para a avaliação dos resultados do tratamento proposto, pode-se subestimar o impacto da doença no dia a dia do paciente. O estado de saúde também deve levar em conta a influência da condição clínica nas diversas situações da vida diária, laboral, recreacional, esportiva e social.…”

“…7,8 Since patellar instability is a multifactorial condition, [1][2][3][4][5][6][7][8][9] it can be managed with several therapeutic options according to the patient's anatomical features and individual presentation. 10 The assessment of the therapeutic outcomes using clinical and radiographic criteria alone may underestimate the impact of the disease on the daily life of the patient. The health status should take into consideration the influence of the clinical condition in different daily life, work, recreation, sports and social scenarios.…”

Why Do Patellofemoral Stabilization Procedures Fail? Keys to Success

“…Surgery for PF instability has received great attention in recent years and the failure of procedures and complications are still relatively common. The most popular and concomitant procedures for patellar instability are medial patellofemoral ligament (MPFL) reconstruction, lateral retinacular lengthening, tibial tubercle osteotomies (TTO), de-rotation osteotomies, and trochleoplasty [2,3]. The isolated lateral release procedure is known to yield unpredictable outcomes, yet it remains a common procedure performed by non-expert patellofemoral surgeons [4].…”