Skip to main content
SpringerLink
Log in

Arthroscopic Patellar Instability Surgery

  • Living reference work entry
  • First Online:
Sports Injuries

  • 216 Accesses

Abstract

Biomechanically the knee joint has motion complex which includes gliding, rolling, translation, and rotation during their extension to flexion. A significant incidence of knee pain and disability arises from patellofemoral disorders in all ages. Patellar instability is a subjective term that defines pain, blockage, and clinical twisting due to the deterioration of the static and dynamic knee extensor mechanism. An accurate diagnosis relies both on assessing soft tissues and bony tissues together and considering pelvic and spinal stabilizers. Under the title of patellar instability, arthroscopic medial plication technique and the importance of the medial patellofemoral ligament in this approach will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Ahmad CS, Stein BE, Matuz D et al (2000) Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. A review of eight cases. Am J Sports Med 28(6):804–810

    PubMed  CAS  Google Scholar 

  • Ali S, Bhatti A (2007) Arthroscopic proximal realignment of the patella for recurrent instability: report of a new surgical technique with 1 to 7 years of follow-up. Arthroscopy 23:305–311

    Article  PubMed  Google Scholar 

  • Boden BP, Pearsall AW, Garrett WE Jr et al (1997) Patellofemoral instability: evaluation and management. J Am Acad Orthop Surg 5:47–57

    PubMed  Google Scholar 

  • Colvin AC, West RV (2008) Patellar instability. J Bone Joint Surg Am 90:2751–2762

    Article  PubMed  Google Scholar 

  • Conlan T, Garth WP Jr, Lemons JE (1993) Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 75(5):682–693

    PubMed  CAS  Google Scholar 

  • Deie M, Ochi M, Sumen Y (2005) A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation. Knee Surg Sports Traumatol Arthrosc 13:522–528

    Article  PubMed  Google Scholar 

  • Dejour D, Le Coultre B (2007) Osteotomies in patello-femoral instabilities. Sports Med Arthrosc 15(1):39–46

    Article  PubMed  Google Scholar 

  • Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65

    PubMed  CAS  Google Scholar 

  • Doral MN, Atik OŞ, Şener E (1988) Patellar malalignmentta artroskopik lateral fasyal gevşetme. Acta Orthop Traumatol Turc 22:252–254

    Google Scholar 

  • Doral MN, Tandoğan R, Acaroğlu E et al (1992) Arthroscopically assisted closed lateral capsular release in the treatment of patellar instability and anterior knee pain syndromes in professional athletes. Proc Int Arthrosc Cong Mapere Med 3(Suppl 3):10

    Google Scholar 

  • Doral MN, Turhan E, Donmez G (2009) Diz artroskopisi: Artroskopik patellar instabilite cerrahisi. Turkiye Klinikleri J Orthop Traumatol-Spec Top 2(3):80–87

    Google Scholar 

  • Elias JJ, Cosgarea AJ (2006) Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis. Am J Sports Med 34:1478–1485

    Article  PubMed  Google Scholar 

  • Fithian DC, Paxton EW, Stone ML et al (2004) Epidemiology and natural history of acute patellar dislocation. Am J Sports Med 32:1114–1121

    Article  PubMed  Google Scholar 

  • Fulkerson JP (1997) Disorders of the patellofemoral joint, 3rd edn. William & Wilkins, Philadelphia, pp 211–214

    Google Scholar 

  • Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30:447–456

    PubMed  Google Scholar 

  • Hawkins RJ, Bell RH, Anisette G (1986) Acute patellar dislocations. The natural history. Am J Sports Med 14:117–120

    Article  PubMed  CAS  Google Scholar 

  • Kaya D, Atay OA, Callaghan M et al (2009) Hallux valgus in patients with patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc 17(11):1364–1367

    Article  PubMed  Google Scholar 

  • Lattermann C, Toth J, Bach BR Jr (2007) The role of lateral retinacular release in the treatment of patellar instability. Sports Med Arthrosc 15:57–60

    Article  PubMed  Google Scholar 

  • Menz HB, Lord SR (2005) Gait instability in older people with hallux valgus. Foot Ankle Int 26(6):483–489

    PubMed  Google Scholar 

  • Nam EK, Karzel RP (2005) Mini-open medial reefing and arthroscopic lateral release for the treatment of recurrent patellar dislocation: a medium-term follow-up. Am J Sports Med 33:220–230

    Article  PubMed  Google Scholar 

  • Neyret P, Robinson AH, Le Coultre B (2002) Patellar tendon length–the factor in patellar instability? Knee 9(1):3–6

    Article  PubMed  Google Scholar 

  • Nikku R, Nietosvaara Y, Kallio PE et al (1997) Operative versus closed treatment of primary dislocation of the patella. Similar 2-year results in 125 randomized patients. Acta Orthop Scand 68(5):419–423

    Article  PubMed  CAS  Google Scholar 

  • Nomura E (1999) Classification of lesions of the medial patellofemoral ligament in patellar dislocation. Int Orthop 23(5):260–263

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Nomura E, Inoue M, Kurimura M (2003) Chondral and osteochondral injuries associated with acute patellar dislocation. Arthroscopy 19(7):717–721

    Article  PubMed  Google Scholar 

  • Ostermeier S, Stukenborg-Colsman C, Hurschler C (2006) In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability. Arthroscopy 22:308–319

    Article  PubMed  Google Scholar 

  • Ostermeier S, Holst M, Bohnsack M (2007) In vitro measurement of patellar kinematics following reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 15:276–285

    Article  PubMed  Google Scholar 

  • Panagopoulos A, van Niekerk L, Triantafillopoulos IK (2008) MPFL reconstruction for recurrent patella dislocation: a new surgical technique and review of the literature. Int J Sports Med 29:359–365

    Article  PubMed  CAS  Google Scholar 

  • Panni AS, Tartarone M, Patricola AA (2006) Patellofemoral problems. In: Volpi P (ed) Football traumatology – current concepts: from prevention to treatment, 1st edn. Springer, Milan, pp 263–274

    Chapter  Google Scholar 

  • Pınar H, Akseki D, Karaoğlan O (1994) Kinematic and dynamic axial computed tomography of the patello-femoral joint in patients with anterior knee pain. Knee Surg Sports Traumatol Arthrosc 2(3):170–173

    Article  PubMed  Google Scholar 

  • Post WR, Teitge R, Amis A (2002) Patellofemoral malalignment: looking beyond the viewbox. Clin Sports Med 21:521–546

    Article  PubMed  Google Scholar 

  • Satterfield WH, Johnson DL (2005) Arthroscopic patellar “Bankart” repair after acute dislocation. Arthroscopy 21(5):627

    Article  PubMed  Google Scholar 

  • Schutzer SF, Ramsby GR, Fulkerson JP (1986) Computed tomographic classification of patellofemoral pain patients. Orthop Clin North Am 17:235–248

    PubMed  CAS  Google Scholar 

  • Seil R, Muller B, Georg T (2000) Reliability and interobserver variability in radiological patellar height ratios. Knee Surg Sports Traumatol Arthrosc 8:231–236

    Article  PubMed  CAS  Google Scholar 

  • Senavongse W, Amis AA (2005) The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability. J Bone Joint Surg Br 87:577–582

    Article  PubMed  CAS  Google Scholar 

  • Seyahi A, Atalar AC, Koyuncu LÖ (2006) Blumensaat çizgisi ve patella yüksekliği. Acta Orthop Traumatol Turc 40(3):240–247

    PubMed  Google Scholar 

  • Tom A, Fulkerson JP (2007) Restoration of native medial patellofemoral ligament support after patella dislocation. Sports Med Arthrosc 15:68–71

    Article  PubMed  Google Scholar 

  • Warren LA, Marshall JL, Girgis F (1974) The prime static stabilizer of the medical side of the knee. J Bone Joint Surg Am 56(4):665–674

    PubMed  CAS  Google Scholar 

  • White BJ, Sherman OH (2009) Patellofemoral instability. Bull NYU Hosp Jt Dis 67(1):22–29

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Hacettepe University, Hasircilar Caddesi, 06100, Ankara, Turkey

    Mahmut Nedim Doral, Egemen Turhan & Gazi Huri

  2. Department of Sports Medicine, Faculty of Medicine, Hacettepe University, 06100, Ankara, Turkey

    Gürhan Dönmez & Defne Kaya

  3. Department of Orthopaedics and Traumatology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Onur Bilge

  4. Department of Orthopaedics and Traumatology, Acibadem Hospital, 34100, İstanbul, Turkey

    Mustafa Karahan

  5. Department of Orthopaedics and Traumatology, Dr. Lütfi Kırdar Kartal Education and Research Hospital, İstanbul, Turkey

    Nurzat Elmalı

Authors
  1. Mahmut Nedim Doral
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Egemen Turhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gazi Huri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gürhan Dönmez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mustafa Karahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nurzat Elmalı
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Onur Bilge
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Defne Kaya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mahmut Nedim Doral .

Editor information

Editors and Affiliations

  1. Dept. Orthopedics & Traumatology, Hacettepe University Fac. Medicine, Ankara, Turkey

    Mahmut Nedim Doral

  2. Gothenburg, Sweden

    Jon Karlsson

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Doral, M.N. et al. (2014). Arthroscopic Patellar Instability Surgery. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_125-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-36801-1_125-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-36801-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation