Abstract
Extensor mechanism misalignment in the knee, particularly patellofemoral instability (PFI), requires detailed diagnostic and therapeutic approaches. This comprehensive review intends to present recent advancements in diagnostic imaging technologies as well as surgical approaches that have significantly advanced the management of this condition. An extensive literature review covered recent studies and clinical practices related to diagnosing and treating knee extensor mechanism misalignment, such as three-dimensional imaging technologies, arthroscopic surgical techniques, postoperative rehabilitation protocols, and others. Three-dimensional imaging technologies such as MRI and CT scans have revolutionized diagnosing and managing PFI by providing detailed assessments of anatomical anomalies, leading to personalized treatment plans tailored specifically for each individual's anatomy. Arthroscopic surgery, with techniques such as lateral release, medial patellofemoral ligament reconstruction, and tibial tubercle osteotomy, has become an efficient minimally invasive solution, with advancements like digitally calibrated measurement tools further improving surgical precision and outcomes. The combined use of advanced imaging technologies and surgical methods has greatly advanced the management of knee extensor mechanism misalignment. Personalized medicine approaches combined with minimally invasive surgical techniques have yielded promising recovery times and outcomes, and future directions include exploring biological therapies, improving rehabilitation protocols, and expanding diagnostic technologies to address misalignments more comprehensively. With modern diagnostic tools and innovative surgical techniques, more effective and personalized treatments for extensor mechanism misalignment in the knee have become possible. These advances could significantly enhance the quality of life for individuals suffering from PFI disorders; ongoing research collaboration should serve to optimize diagnosis, treatment, and prevention strategies further.