Management of patellofemoral instability in the setting of multiligament knee injury

The term multiligament knee injury (MLKI) is applied to various injury patterns involving two or more of the major knee ligaments. While often overlooked, it is also essential to evaluate and recognize injury patterns to the medial and lateral stabilizers of the patellofemoral (PF) joint. To date, there is limited literature discussing the treatment of patellar instability in the setting of multiligament knee injuries. The review seeks to provide a clinically relevant guide to the evaluation and management of patella instability in the setting of the MLKI. We will emphasize key differences in patient demographics, injury mechanism, and presence of concomitant pathology as compared to isolated PF instability that will guide prognosis and treatment decision making.