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Patellar Instability

Patellar instability occur when the patella, or knee cap is displaced from its resting place.



  • A hand blow or a fall
  • Traumatic ligament laxity
  • Atraumatic


Patellar instability can be classified into


  • Acute traumatic
  • Occur after a direct blow – collision in the foots or hit against a hard surface during a fall
  • Chronic recurrent subluxation episodes occur more in women associated with maliagments
  • Habitual-usually painless
  • Occur during flexion
  • Could be because of tight lateral structures like ITB, vastus laterials



  • Instability
  • Anterior knee pain
  • Medial side tenderness
  • Patella apprehension




Clinical pattelar apprehension test.




  • MRI- To rule out
  • MPFL team
  • Trochlea hypoplasia
  • Osteochondrol lesion/ or bone brushing on medial patellar facet




Non operative


  • Acute dislocation – immobilization in cast for 3 week followed by supervised rehab for 6 weeks. Main emphasis on VMO strengthning with ITB release.
  • Patellar stabilizing brace.




MPFL repair- if no significant underlying malaligment. Tibial tubercle transfer is done in addition to MPFL reconstruction or in isolation with significant malaligment.