Patellofemoral instability is a condition where the kneecap shifts out of its normal position, usually toward the outside of the knee. This can cause pain, swelling, and a sense of giving way. Over time, it may damage the cartilage surfaces in the knee joint.
Dr. Reza Jazayeri is a double board-certified orthopedic surgeon specializing in sports medicine. He provides treatment for this condition at his Beverly Hills, Westlake Village, and Orange offices.
He has over 15 years of experience treating athletes, active adults, and combat sports practitioners. His approach starts with a thorough evaluation to determine the most appropriate path forward for your specific situation.
Basic Patellofemoral Anatomy and Alignment
The patella sits in a groove at the end of the thigh bone (femur) called the trochlear groove, where it glides as the knee bends and straightens.
The kneecap is stabilized by a combination of:
- Ligaments, especially the medial patellofemoral ligament (MPFL), which prevents lateral dislocation.
- Surrounding muscles, primarily the quadriceps.
Bony alignment includes the shape of the trochlear groove and the position of the tibial tubercle (where the patellar tendon inserts below the kneecap).
If the groove is shallow or the alignment of the leg is off, the kneecap is more likely to dislocate or shift out of place.
Diagnosis and Imaging
Dr. Jaz performs a detailed physical examination and orders specific imaging studies to evaluate both soft tissue and bony anatomy. These typically include:
- X-rays to assess alignment and bone structure
- MRI scans to evaluate the MPFL and check for cartilage damage
- CT scans in select cases to measure bone alignment in greater detail and guide surgical planning
These studies help determine whether non-surgical or surgical treatment is most appropriate.
Non-Operative Treatment Options
Non-operative care may be appropriate in certain cases, especially:
- First-time dislocations without major cartilage injury
- Partial dislocations (subluxations) that spontaneously reduce
- Patients with minimal pain and good muscular control
Treatment typically includes physical therapy, bracing, and activity modification. However, in some patients, even a first-time dislocation can lead to significant cartilage damage or persistent instability—warranting early surgical consideration.
When Surgery Is Recommended
Surgical treatment is often advised in the following situations:
- Recurrent dislocations or chronic instability
- Persistent symptoms that interfere with sports or daily activity
- Cartilage injury or significant damage on MRI
- Underlying anatomical abnormalities contributing to instability
Early stabilization can help prevent long-term cartilage damage and lower the risk of future arthritis.
Surgical Options
MPFL Reconstruction and Tibial Tubercle Osteotomy (TTO) Dr. Jaz tailors the surgical plan based on your anatomy, imaging, age, activity level, and personal goals. The two main procedures used to stabilize the kneecap are:
1. Medial Patellofemoral Ligament (MPFL)
Reconstruction Replaces the torn MPFL with a graft.
- Restores the main soft tissue restraint that prevents lateral dislocation
- Most effective in patients with normal bone alignment but a torn ligament
2. Tibial Tubercle Osteotomy (TTO)
Realigns the insertion point of the patellar tendon by shifting the tibial tubercle.
- Corrects bony malalignment
- Often performed in combination with MPFL reconstruction in patients with both ligament injury and abnormal bone alignment
Advanced Imaging and Personalized Surgical Planning
For patients requiring osteotomy procedures, Dr. Jazayeri utilizes the most current imaging technology and patient-specific surgical tools. Working with the innovative team at Bodycad Bodycad, Dr. Jazayeri employs proprietary Personalized Restoration™ Software to design individualized surgical plans and implants.
Bodycad’s cutting-edge platform allows for:
- Personalized 3D planning based on your unique bone anatomy
- Custom bone models and patient-specific instrumentation using advanced 3D printing
- Enhanced precision, accuracy, and reproducibility during surgery
By integrating this technology, Dr. Jazayeri is able to offer the most reliable and precise osteotomy procedures available—tailored to the specific needs of each patient.
Personalized Treatment Plans
Not every patient will need both procedures. Dr. Jazayeri carefully considers multiple factors before making a recommendation:
- Age and skeletal maturity
- Sport and activity level
- Physical exam findings
- Imaging measurements such as TT-TG distance, patella height, and trochlear dysplasia
- Goals and expectations for recovery
Each surgical plan is individually customized to optimize outcomes and help patients return to their active lifestyles with stability and confidence.
Watch: MPFL Reconstruction Using 3.9 mm BioComposite SwiveLock® Implant Kits
Watch: Tibial Tubercle Osteotomy (TTO) with Arthrex® T3 AMZ System
Watch: Patellar Dislocation of the Knee – See How It’s Repaired – 3D Animation
Frequently Asked Questions
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Patellofemoral instability happens when the kneecap doesn’t track properly in its groove. This can be due to anatomical issues, ligament laxity, or high-impact sports activities.
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People with patellofemoral instability often experience pain in the front of the knee, especially during activities like climbing stairs or squatting. Swelling and a feeling that the knee might give way are also common symptoms.
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Non-surgical options include physical therapy, bracing, and modifying activities to strengthen the knee. These methods aim to improve patellar tracking and reduce pain without the need for surgery.
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Surgery may be needed if there are recurrent dislocations or significant cartilage damage. Procedures like MPFL reconstruction or tibial tubercle osteotomy can help stabilize the kneecap.
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Rehabilitation duration varies, but most patients can expect several months of recovery. The process includes protecting the knee, restoring motion, and gradually increasing strength through physical therapy.
Why Choose Us For Patellofemoral Instability Treatment?
We understand how challenging patellofemoral instability can be. Dr. Reza Jazayeri is a double board-certified orthopedic surgeon with over 15 years of experience.
He specializes in sports medicine and has treated many patients with knee issues. His focus is on finding the best treatment plan for each patient, whether that means exploring non-surgical options first or considering surgery.
Our approach combines advanced surgical techniques with personalized recovery protocols. Dr. Jaz believes in treating every patient like family.
He coordinates with skilled physical therapists to ensure you get the best care possible. Whether you need rehabilitation after surgery or non-surgical treatments, we are here to support you every step of the way.
Meet Dr. Reza Jazayeri
Dr. Reza Jazayeri specializes in sports medicine with expertise in shoulder, knee, and elbow injuries. A Southern California native, Dr. Jazayeri combines an engineering background with elite surgical training, completing his orthopedic surgery residency at the nationally ranked NYU Hospital for Joint Diseases and a sports medicine fellowship at the renowned Kerlan-Jobe Orthopaedic Clinic.
After more than 15 years caring for patients within the Southern California Permanente Medical Group, Dr. Jazayeri joined DOCS Health to expand a practice focused on personalized orthopedic and sports medicine care and surgical excellence. As Director of Longevity at DOCS Health, he leads the development and implementation of optimization protocols and regenerative medicine strategies designed to improve long-term musculoskeletal health and extend healthspan.
His published work includes a 2026 coauthored review of nutritional optimization in spine surgery in the Journal of the American Academy of Orthopaedic Surgeons. View Dr. Jazayeri’s research publications and training.
Dr. Jazayeri instilled a sense of calm & trust before my knee surgery. His unwavering dedication & commitment to patient care are truly inspiring. Thank you very much for the outstanding expertise & compassionate care. I’m extremely grateful. Yuko Hori
Consult With An Orthopedic Surgeon Today
If you are dealing with patellofemoral instability, a thorough evaluation is the first step toward a stable, functional knee. Dr. Reza Jazayeri is a double board-certified orthopedic surgeon with over 15 years of experience treating knee conditions in athletes and active adults.
Virtual consultations are available for patients across California and beyond. His practice combines advanced surgical techniques with nutritional optimization and personalized recovery protocols.
Every patient receives the same level of care he would give to his own family and friends. Reach out today our Beverly Hills, Westlake Village, or Orange office to discuss your treatment options.
Medically reviewed by Reza Jazayeri, M.D. on
