Lateral Patellofemoral Ligament Reconstruction: Anatomy, Biomechanics, Indications, and Surgical Techniques

Medial patellar instability is less common than lateral instability and is almost always iatrogenic in nature. The lateral patellofemoral complex, and in particular the lateral patellofemoral ligament, is a major restraint to medial displacement of the patella. When considering surgical intervention, a comprehensive evaluation including understanding of previous procedures and presence of additional risk factors for instability, such as trochlear dysplasia, malalignment, or patella alta must be ruled out. This paper highlights recent anatomic and biomechanical evidence for the treatment of medial patellar instability as well as the pearls and pitfalls for a successful lateral patellofemoral ligament reconstruction.