Arthroscopic Management of Patellar Instability

Several arthroscopic techniques have been described to address patellar instability. Most arthroscopic procedures focus on soft-tissue plication or “tightening” of the medial retinacular structures to correct lateral patellar instability. Good results have been reported using these techniques; however, we have found these techniques to be ineffective when the medial stabilizers have been avulsed from the patella. As a result, we have developed an arthroscopic technique to repair medial patellofemoral ligament avulsions to the patella using suture anchors. The purpose of this article is to review our indications for arthroscopic management of patellar instability and describe our 2 most common techniques.