Introduction Acute patellar dislocation is a common knee injury in adolescents and young adults, with primary patellar dislocations occurring at a rate of 42 per 100,000 person-years. However, the vast majority of primary and recurrent dislocations are in a lateral…
Introduction Lateral patellar instability is a common knee disorder, particularly in children and adolescents. Its aetiology is multifactorial, and typically it is caused by a combination of soft tissue and osseous abnormalities, such as medial patellofemoral ligament (MPFL) incompetency, dysplasia,…
Intrinsic and Extrinsic Limb Factors It is the author’s opinion that patellofemoral (PF) symptoms should be considered as those that arise from the joint itself and are considered intrinsic factors and those that are caused by forces external to the…
Introduction Normal patellar tracking is mediated statically by the bone structures, passively by the soft tissue stabilisers and actively by the musculature about the knee. Patellofemoral tracking relates to contact because the patella is physiologically intended to be centred within…
Patellofemoral Instability The patellofemoral joint (PFJ) is a highly complex structure, intimately associated with the dynamic muscle activity, including the global and central control of the limb, which is linked to the pelvis and the spine. The function of the…
Medial Patellofemoral Anatomy Proximal Medial Patellar Complex As our understanding of medial patellofemoral anatomy continues to grow, the implications for surgical reconstruction have evolved. Whereas earlier reports focused on reconstruction of the medial patellofemoral ligament (MPFL) as the primary treatment…
Introduction The term osteonecrosis was first described by Ahlback et al. in 1968. The original description involved the spontaneous appearance of what was thought to represent focal osteonecrosis of the femoral condyle. After the hip, the knee has been determined to…
Introduction Osteoarthritis (OA) is a debilitating condition that can lead to chronic pain, disability, decreased quality of life and inability to perform activities of daily living. Authors have reported that OA and diabetes are responsible for the largest increase in…
Introduction Osteochondritis dissecans (OCD) is a focal, pathological lesion involving subchondral bone and the attached overlying articular cartilage. Importantly, the focal lesion is at subsequent risk for the development of subchondral degeneration, destabilisation of the lesion from the articular surface,…
Introduction Focal chondral defects ( FCDs ) constitute a common finding, with a reported incidence of 4.2% and 6.2% in the general population in patients younger than 40, resulting in more than 200,000 surgical procedures per year ( Fig. 22.1…