Surgical treatment for patellar instability.

The initial therapy for patellofemoral pain remains conservative. Once this treatment plan fails and examination has clearly identified the cause of the patellofemoral dysfunction, surgical treatment is considered. No single procedure corrects all patellofemoral problems, and the patient's age, the causative factor, the condition of the articular surface, and the level of activity should be considered. Surgical options include lateral retinacular release, proximal realignment, distal realignment, and proximal and distal realignment.