Medial Patellar Instability: Primary and Iatrogenic

Alexander E. Loeb, Andrew J. Cosgarea, Jack Farr

Research output: Chapter in Book/Report/Conference proceedingChapter


Medial patellar instability, in both noniatrogenic and iatrogenic settings, is rare compared with lateral patellar instability. Although iatrogenic medial patellar dislocation is most often considered a complication of a lateral retinacular release, improperly performed patellofemoral procedures such as tibial tubercle osteotomy and medial patellofemoral ligament reconstruction can also be contributing factors. As a result, a thorough history and physical examination are paramount. Because of the sparse evidence for medial patellar instability treatment, management should follow that of lateral patellar instability: first-time dislocators without significant risk of recurrence or osteochondral fracture should initially be managed nonoperatively, whereas recurrent dislocators and those having failed conservative treatment are surgical candidates. Treatment is empiric at this point and is directed at contributing pathological conditions; most commonly, that is reversal of iatrogenic pathological conditions such as repair or reconstruction of a prior excessive lateral release. In this chapter we highlight what is understood about the unusual pathological condition of medial patellar instability, both in the noniatrogenic and iatrogenic settings.

Original languageEnglish (US)
Title of host publicationEvidence-Based Management of Complex Knee Injuries
Subtitle of host publicationRestoring the Anatomy to Achieve Best Outcomes
Number of pages5
ISBN (Electronic)9780323713108
ISBN (Print)9780323713115
StatePublished - Jan 1 2020


  • lateral release complications
  • medial patellar dislocation
  • medial patellar instability
  • medial patellofemoral ligament complications
  • tibial tubercle medialisation complications

ASJC Scopus subject areas

  • Medicine(all)


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