**4.2 Operative treatment**

Operative treatment for patients with recurrent patellar instability should be directed at the underlying causative pathoanatomy that can be determined by careful history-taking, meticulous physical examination, and pertinent radiographic studies. We emphasize an individualized treatment approach rather "one-size-fits-all" approach. Surgical intervention should be based on clear understanding of the underlying pathoanatomic risk factor(s) and radiographic abnormality as shown below:


Patients with recurrent patellofemoral instability often have multiple anatomical and/or radiographic risk factors. In such a scenario, a combination of abovementioned surgical procedures is necessary to restore patellar stability.
