Combined Proximal and Distal Realignment for Recurrent Patellofemoral Instability Proximal Realignment with Cartilage Restoration for Patellar Instability and Chondromalacia Patellofemoral Arthroplasty for Isolated Arthritis in the Setting of Patellar Instability

Patellofemoral problems often begin with instability in young patients and become progressively disabling. Effective treatment requires understanding a complex combination of knee alignment, soft tissue influences on patellar tracking and stability, joint forces and the condition of articular surfaces. Management of patellofemoral conditions usually begins with directed physical therapy, various forms of bracing and activity modification. When these measures are not successful, increasing pain and disability, with progressive damage to articular surfaces, are strong indications to intervene.