Data source: Using MEDLINE, the article research based on the query “patellofemural instability AND treatment”. These were selected by the title, abstract and availability of fulltext. Some data were obtained from the book “Patellofemural Pain, Instability, and Arthritis” by Stefano Zaffagnini et al.

 

Results: 67 articles were included.

 

Data synthesis: The initial treatment for patellofemural instability should be nonoperative except if LMPF rupture, osteocondral lesion or other risk factors for future dislocation are present. Then a ligament reconstruction is indicated. The results with the Galeazzi or Roux- Goldthwait procedure weren’t favourable in the adult, with the second dislocation, as the LMPF reconstruction. However, still remain in the first line treatment for children and adolescents. The Elmeslie-Trillat procedure is considered the most important intervention for the treatment of patellar dislocation with patella alta and/or pathological TT-TG. Artroscopic deepening throcleoplastia is the best response to trochlear displasia (type B and D), but should only be considered in very restrict cases.

 

Conclusion: The patellar instability remains an area of great controversy. Nevertheless, big steps have been given toward a better understanding and classification of this pathology. LMPF reconstruction is a main option for the treatment of objective patellar instability. Other options like certain trochleoplasties and derotacional osteotomies are reserved for exceptional situations.

 

 

Key-words: Patellofemural instability; treatment; Controversy.