This 2008 JBJS current concepts review by Colvin and West systematically covers the anatomy, radiographic assessment, and operative decision-making for patellar instability — asking which structural abnormalities are present and which procedure best addresses them.
When a patient has recurrent instability with normal TT-TG and normal patellar height, think MPFL reconstruction; when TT-TG is elevated or patella alta is present, think tibial tubercle transfer — and avoid distal realignment if medial or proximal patellar chondrosis is present, as it overloads already-degenerated tissue.
Isolated lateral release should not be offered for instability at any stage.
This 2008 JBJS current concepts review by Colvin and West systematically covers the anatomy, radiographic assessment, and operative decision-making for patellar instability — asking which structural abnormalities are present and which procedure best addresses them.
When a patient has recurrent instability with normal TT-TG and normal patellar height, think MPFL reconstruction; when TT-TG is elevated or patella alta is present, think tibial tubercle transfer — and avoid distal realignment if medial or proximal patellar chondrosis is present, as it overloads already-degenerated tissue.
Isolated lateral release should not be offered for instability at any stage.