Master the complexities of patellofemoral instability in this comprehensive orthopaedic masterclass. We explore critical anatomical risk factors using the PATELLA mnemonic, acute dislocation managementand the 'a-la-carte' surgical approach to patellar stabilisation. ⏱ Chapters 0:00 Intro 0:26 Essentials 1:11 Risk Factors 2:00 Imaging Signs 2:39 Dejour 3:18 Recurrence 3:52 Flap 4:19 Algorithm 5:14 Safe 5:43 Numbers 6:30 Clinical Reasoning 1 7:05 Clinical Reasoning 2 Patellofemoral instability is a common yet complex condition requiring a deep understanding of knee anatomy and biomechanics. This video provides an in-depth analysis of acute patellar dislocations, the natural history of recurrenceand the comprehensive radiological evaluation required to diagnose trochlear dysplasia and lateral malalignment. We cover everything from initial conservative management and the FLAP indications for early surgery, to MPFL reconstruction, tibial tubercle osteotomyand trochleoplasty. 🦴 IN THIS VIDEO YOU'LL LEARN • How to identify anatomical risk factors for instability using the PATELLA mnemonic • The role of the medial patellofemoral ligament (MPFL) as the primary restraint to lateral translation • How to apply the fifty-eighty rule for dislocation recurrence risk • When to operate on first-time dislocators using the FLAP surgical indications • How to evaluate trochlear dysplasia using the Dejour classification system • The clinical significance of the TT-TG distance and an Insall-Salvati ratio greater than 1.2 • How to recognise the pathognomonic kissing contusion pattern on MRI • The rationale behind the 'a-la-carte' surgical approach for patellar stabilisation • The critical importance of the Schoettle point for MPFL femoral tunnel placement ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ The MPFL provides 50-60% of the restraint to lateral patellar translation in the first 30 degrees of flexion. ✔️ First-time dislocators without loose bodies are managed conservatively but carry a 50% recurrence risk. ✔️ A TT-TG distance greater than 20mm indicates pathological lateral offset warranting a tibial tubercle osteotomy. ✔️ The crossing sign on a lateral radiograph is the most sensitive indicator of trochlear dysplasia. ✔️ Surgical indications after a first dislocation include osteochondral fragments, large MPFL avulsionsand high-risk anatomical abnormalities. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical studentsand sports medicine clinicians seeking a comprehensive understanding of patellar instability. Curious patients looking to understand the surgical rationale for their knee condition will also find it highly informative. 📚 RELATED TOPICS: MPFL Reconstruction Surgical Technique · Tibial Tubercle Osteotomy (TTO) Indications · Sulcus Deepening Trochleoplasty · Assessing Patellar Height: Insall-Salvati vs Caton-Deschamps · Management of Osteochondral Defects in the Knee · Clinical Assessment of the Unstable Knee 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #patellofemoralinstability #patelladislocation #kneesurgery #mpflreconstruction #sportsmedicine #trochleardysplasia #orthopedicsurgery #kneeinstability #mpfl #dejourclassification #orthovellum