Instability of the patellofemoral (PF) joint of the knee is typically caused by chronic atraumatic injuries and inciting traumatic events. Anatomically, bony and softtissue structures surrounding the PF joint and extensor mechanism contribute to overall stability of the area, which results in efficient kinematic function at the PF articulation. Furthermore, physiological, genetic, anatomical, and demographical factors may affect the development and progression of PF joint instability. Treatment techniques have varied owing to individual factors that may have influence on pathological features of the injury. Nonoperative treatment has predominantly focused on strengthening of the quadriceps and vastus medialis by coordinated, closed chain exercises; if unsuccessful, surgical treatment can be a viable option for chronic dislocation and instability of the PF joint. I reviewed anatomy of the patella and notable bony and soft-tissue constructs; radiographic evaluation and findings suspicious of PF joint instability; and common operative and nonoperative methods for treatment. Despite improved understanding of possible causes and outcomes of treating PF joint instability, further clinical studies are necessary to evaluate the long-term clinical impact of treatment. Introductio

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