(Fig 4-A.40) Chronic Patellofemoral Instability: Part 1

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https://youtu.be/vzxclU_34OI?si=B88NykUJHSELzyAC

 

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📌 Chronic Patellofemoral Instability

 

✅ Manifestations of Chronic Patellofemoral Instability

• Fibrosed/thickened/attenuated retinaculum
• Bony productive changes at retinacular attachments
• Ossification of retinacular layers
• Asymmetric retinacular thickening/attenuation

 

✅ Long-term Changes

• Signs of early osteoarthritis on MRI
• Ligamentous ossifications of the medial patella
• Synovial diverticulum or ganglion cyst formation

 

✅ Specific Findings

• Concave impaction deformity of the inferomedial patella (sign of prior lateral patellar dislocation)
• Medial retinaculum less likely to tear in recurrent dislocation with patellofemoral dysplasia

 

✅ Predisposing Factors

• Trochlear dysplasia (abnormally shallow lateral femoral trochlea)
• Patella alta (high-riding patella)
• Abnormal tibial tubercle–trochlear groove (TT-TG) distance
• Femoral anteversion
• Ligamentous laxity

 

References: 

Skeletal Radiol (2012) 41:137–148 

Radiographics. 2010 Jul-Aug;30(4):961-81 

Radiology. 2002 Dec;225(3):736-43 

Radiol Clin N Am 51 (2013) 393–411

#ChronicPatellofemorialInstability, #OsteoarthritisChanges, #LigamentousOssifications, #SynovialDiverticulum, #ConcaveImpactionDeformity, #TrochlearDysplasia, #PatellaAlta, #AbnormalTT-TGDistance, #FemoralAnteversion, #LigamentousLaxity