Abstract
Patellofemoral instability (PFI) is one of the most disabling conditions in the knee, often affecting young individuals. Despite its not uncommon presentation, the underlying biomechanical features leading to this entity are not entirely understood. The suitability of classic physical examination manoeuvres and imaging tests is a matter of discussion among treating surgeons, and so are the findings provided by these means. A potential cause for this lack of consensus is the fact that, classically, the diagnostic approach for PFI has relied on statically obtained data. Many authors advocate for the study of this entity in a dynamic scenario, closer to the actual situation in which the instability episodes occur. In this literature review, we have compiled the available data from the last decades regarding dynamic evaluation methods for PFI and related conditions. Several categories are presented, grouping the related techniques and devices: physical examination, imaging modalities (ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT) and combined methods), arthroscopic evaluation, and others. In conclusion, although a vast number of quality studies are presented, in which comprehensive data about the biomechanics of the patellofemoral joint (PFJ) are described, this evidence has not yet reached clinical practice universally. Most of the data still stays in the research field and is seldom employed to assist a better understanding of the PFI cases and their ideal treatment targets.
Highlights
The patellofemoral joint (PFJ), despite its apparent minor contribution to knee biomechanics, remains to be one of the less understood components in the lower limb
As several musculoskeletal conditions associated with the PFJ are troublesome in terms of diagnosis and successful treatment, there is a growing interest on patellofemoral instability (PFI)[1]
The objective of this review is to summarize the available evidence of the dynamic assessment of PFI; can it be considered a clinical tool, or does it remain a field in need of further research?
Summary
The patellofemoral joint (PFJ), despite its apparent minor contribution to knee biomechanics, remains to be one of the less understood components in the lower limb. As several musculoskeletal conditions associated with the PFJ (e.g. arthritis, anterior knee pain syndrome) are troublesome in terms of diagnosis and successful treatment, there is a growing interest on patellofemoral instability (PFI)[1]. PFI is defined as an abnormal patellar tracking in relation to the femoral trochlea as the knee extends/flexes. PFI can lead to recurrent patellar dislocation, a disabling condition. The list of predisposing factors recognized for PFI is vast, including (but not limited to): patella alta, trochlear dysplasia, increased Q-angle, muscular imbalance, increased femoraltibial torsion, genu valgus, hyperlaxity, and traumatic rupture of stabilizers such as the medial patellofemoral ligament[2,3,4,5]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call