ARTHRITIS
The management options for secondary arthritis due to chronic PTFJ instability have rarely been discussed in the literature. Arthrodesis or fibular head resection are options for the treatment of arthritis, and the above discussion applies here as well. Yaniv and colleagues40 describe a technical procedure for addressing both instability and secondary joint arthritis. The authors performed a ligament reconstruction of the PTFJ using the anterior part of the biceps femoris combined with interpositional joint arthroplasty using a vascularized fascia lata strip. Two weeks post-operation, the patient was walking with full weight-bearing and 6 weeks post-operation the first sports activities were allowed.40
CONCLUSION
Conditions affecting the PTFJ, their diagnosis, and treatment are infrequent topics of discussion in the literature. While PTFJ injury, instability, and other disease states are admittedly rare, clinicians need to include them in the differential diagnosis of patients presenting with lateral knee complaints. Diagnostic imaging is a critical component in early identification of PTFJ conditions to prevent long-term complications. Most injuries are treated first with conservative methods, reserving surgery as an option when first-line measures are unsuccessful. Advancements in surgical options for dislocation and subluxation/chronic instability of the joint have been made, but further research on their effectiveness and long-term outcomes is needed before a gold-standard treatment can be determined.