Learning Objectives:

1. Identify the key anatomical contributors to patellar stability, including bony and soft-tissue structures, and how abnormalities in each predispose to instability.
2. Perform a focused physical exam for suspected patellar dislocation, recognizing clinical signs of acute injury, patellar maltracking, and concerning exam findings that warrant imaging or referral.
3. Interpret relevant imaging modalities (X-ray, MRI, and CT) and identify the major anatomic risk factors for recurrent instability including trochlear dysplasia, patella alta, and elevated TT–TG distance.
4. Differentiate between candidates for conservative management and those who may benefit from early surgical intervention based on patient-specific anatomy, clinical findings, and risk factors.
5. Apply an updated, stepwise treatment algorithm (“menu à la carte”) to guide optimal decision-making for recurrent patellar instability, including understanding the indications for MPFL reconstruction, tibial tubercle osteotomy, and trochleoplasty.