The Evolution of Patellofemoral Instability Surgery During the Past 25 Years.

Surgical treatment of patellofemoral instability has evolved during the past 25 years as we developed a better appreciation of anatomy and a more sophisticated understanding of pathophysiology. Currently, most patellofemoral surgeons use soft tissue procedures like medial patellofemoral ligament reconstruction to treat medial soft tissue insufficiency and tibial tuberosity or femoral osteotomy to correct substantial bony malalignment. Advances in imaging technology and computational analysis have allowed for more precise preoperative planning and outcome modeling so that the optimum operation using ≥1 of these procedures can be designed to meet the unique needs of an individual patient.