Advances in Patellofemoral Disorders

Numerous advances continue to be made and have contributed to the improvement of the diagnosis and treatment of patellofemoral (PF) disorders. These include technological advances in instrumented laxity, 3D and dynamic CT imaging and computational modeling, devices for implantation, and developments in the field of orthobiologics. The Porto Patellofemoral Testing Device (PPTD) provides a standardized stress-testing system simultaneously during an MRI or CT scan to quantify patellar position and displacement with excellent reliability, accuracy, precision, and low variability as compared to manual physical exam. The use of dynamic CT has begun to improve our ability to quantify the contribution of each pathoanatomic variant on patellar tracking throughout knee range of motion (ROM) and provides a better understanding of the biomechanical effects that corrective surgical techniques have on patellar tracking. Utilizing finite element modeling (FEM), researchers have been able to evaluate the kinematic behavior of PF articulation in various disease settings and simulate morphological changes using patient-specific models. Suture tape augmentation of medial patellar stabilizers repair can be safely performed without an increase in contact. In summary, application of these advances to growing areas of inquiry studying PF disease has led to avenues of tremendous potential to improve our ability to accurately diagnose and treat patellofemoral disorders.