Patellofemoral Instability other wise known as Dislocated or Subluaxtion of the Patella. The injury can come from a direct blow or a noncontact twisting of the knee.

The most common mechanism for a patellar dislocation is a forceful inward rotation of the body on a planted foot. Athletes may describe the feeling as the knee giving out.

In an acute patellar dislocation, when a tear of the MPFL is identified, surgical repair (fixing the original ligament) of the MPFL may be a good treatment option. In the young athletic population, recurrence rates for patients treated conservatively are high with some studies reporting 40%. 

Proper stabilization of the patella is also affected by the soft tissue structures (ligaments and muscles) surrounding the knee. The medial patellofemoral ligament (MPFL) is a continuation of the deep retinaculum and vastus medialis oblique (VMO) muscle fibers (inner portion of the quadriceps muscle) on the inside of the knee. 

Return time varies depending on the degree of soft-tissue damage. A return to sport might require almost three months. A post-op recovery requires a period of bracing followed by physical therapy and post-PT training, delaying return time for up to six months.

In recurrent or chronic patellar dislocations, it may be necessary to perform reconstruction of the MPFL. Reconstruction differs from repair in that graft tissue (such as a hamstring tendon) is used to replace or reinforce the MPFL.

Surgery tends to have excellent results in preventing further dislocations, however athletes may have residual pain. 

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