This article summarizes the latest research related to pediatric patellar instability. The epidemiology, patterns of patellar instability, and underlying pathoanatomy are unique in children and adolescents. Information related to the natural history and predictive factors of patellar instability in young patients would allow for better patient counseling and management decisions. The components of nonoperative treatment for first patellar dislocation are outlined. Physeal-respecting surgical techniques, including medial patellofemoral ligament reconstruction in skeletally immature patients, are discussed. The indications and outcomes for quadricepsplasty to address more complex instability patterns are presented. Evaluation and management strategies for specific anatomic risk factors is provided.
