The Evolution of Patellofemoral Instability Surgery During the Past 25 YearsBest, Matthew J., MD; Cosgarea, Andrew J., MDSports Medicine and Arthroscopy Review: December 2018 - Volume 26 - Issue 4 - p 157–159 doi: 10.1097/JSA.0000000000000221 Review Articles Buy SDC Abstract Author InformationAuthors Article MetricsMetrics Surgical treatment of patellofemoral instability has evolved during the past 25 years as we developed a better appreciation of anatomy and a more sophisticated understanding of pathophysiology. Currently, most patellofemoral surgeons use soft tissue procedures like medial patellofemoral ligament reconstruction to treat medial soft tissue insufficiency and tibial tuberosity or femoral osteotomy to correct substantial bony malalignment. Advances in imaging technology and computational analysis have allowed for more precise preoperative planning and outcome modeling so that the optimum operation using ≥1 of these procedures can be designed to meet the unique needs of an individual patient. Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD Disclosure: The authors declare no conflict of interest. Reprints: Andrew J. Cosgarea, MD, Department of Orthopaedic Surgery, The Johns Hopkins University, 10753 Falls Road, Lutherville, MD 21093. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.