Abstract
Medial instability of the patella is most often an iatrogenic condition following surgery for patellofemoral pain or instability. Most often the instability is associated with a previous extensive lateral retinacular release for anterior knee pain without instability.
The symptoms usually involve pain and a sense of medial subluxation at unpredictable times. The clinical diagnosis is based on increased medial laxity of the patella and apprehension with medial translation. A positive gravity subluxation test is often present.
If symptomatic treatment, bracing, and other conservative measures fail, surgery may be helpful. Repair of the vastus lateralis tendon near the proximal patella is usually necessary. The lateral retinaculum should also be reconstituted. At times this can be done with direct repair of the retinacular edges. More frequently the scar tissue filling the defect must be imbricated.
Medial retinacular release has also been reported to be a successful intervention.
The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au
