Review ArticlesNonoperative Treatment of Patellar InstabilityDixit, Sameer MD; Deu, Rajwinder S. MDAuthor Information Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD Disclosure: The authors declare no conflict of interest. Reprints: Sameer Dixit, MD, Department of Orthopaedic Surgery, The Johns Hopkins University, 10753 Falls Road, Lutherville, Baltimore, MD 21093. Sports Medicine and Arthroscopy Review: June 2017 - Volume 25 - Issue 2 - p 72-77 doi: 10.1097/JSA.0000000000000149 Buy Metrics Abstract The treatment of patellar instability is challenging and typically begins with nonoperative methods. Clinical decisions are made on an individual basis and may vary according to a number of factors. First-time patellar dislocations most commonly occur during sports participation. Initial evaluation, including patient history, physical examination, and appropriate imaging, determines care. Although nonoperative treatment consists primarily of regressive immobilization and physical therapy, there is little evidence to support particular protocols for either. Factors that may contraindicate nonoperative treatment include osteochondral lesions and recurrent instability. In these cases, surgery is considered. Reported recurrence rates after nonoperative treatment of acute patellar dislocation are 15% to 44%. Well-designed studies are needed to determine not only the outcomes of nonoperative versus surgical treatment of patellar instability but also the risk factors that may predict poor outcomes in either group. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.