Diagnostic Therapeutic Attitude in Patello Femoral Instability |Biomedgrid

With the anamnesis and exploration, we must differentiate between two situations that can occur exclusively or concomitantly: a. Instability is the impression of imminent dislocation that the patient feels when, with the knee between 0˚-30˚ of extension and the quadriceps relaxed, displacement is forced in patella lateral direction [1,2]. The “dynamic apprehension sign” [3] consists of the “relief of the imminent sensation of dislocation when it is stopped simultaneously with the pressure on the external side while pushing outwards and distally from the internal” which has 100% sensitivity and 88.4% specificity regarding dislocation under anaesthesia, which is the sure sign of instability. b. Patellar mal tracking is the medialization movement of the patella in the first degrees of flexion, it is pronounced, abrupt, greater than 4mm, it is called the “J sign”, it is a characteristic sign of malalignment, although not pathognomonic [4,5].