Complications of patello-femoral joint surgery

Disorders of the patello-femoral joint include a multiplicity of conditions; anatomic abnormalities, overuse injuries, instabilities, trauma, and pain disorders, just to list a few. These present challenges in both diagnosis and management. Multiple surgical treatments have been developed to treat the various and overlapping conditions. These techniques can be divided into soft-tissue, bony, or combined procedures, based on the structure being treated. Within each of these broad categories many specific techniques have evolved. In the soft-tissue grouping, these include lateral retinacular release, vastus medialis reefing or advancement, and various tethering procedures. Bony procedures involve osteotomy and transfer of the tibial tubercle to either elevate or medialize the attachment of the patellar tendon. These proximal or distal techniques can also be performed simultaneously in the combined procedures. Through a careful review of the literature we have identified the potential complications of each procedure. Techniques to reduce the incidence of these complications and treat them, should they arise, are defined. The reader should be able to reduce complications related to treatment of the various patella maladies by this review.