Patellar instability - An update

This review is a current concept on the topic of patellofemoral instability purposing to highlight, reflect and in cooperate both recent important findings regarding the patellofemoral joint. In the past decade numerous studies have significantly contributed to our understanding of both the epidemiology, symptomatology and underlying pathomorphology of patella instability. The topic of patella instability is very complex and several biomechanical important factor have been elucidated and consequently treatment strategies are changing.  Both non-surgical as well as surgical algorithms are evolving, but still there is a lot of controversies and generally there is lack of consensus. Many different surgical options exist primarily based upon repair what have been torn, or by correcting the underlining pathomorphology. Reconstruction of the medial patellofemoral ligament is the most commen surgical procedure, nevertheless in cases with more severe underlining pathomorphologic factors such as trochlear dysplasia, patella alta and increased femoral anteversion, subsequent procedures correcting those abnormalities should be corrected.