Table 1.

The authors’ indications for conservative vs surgical treatment. The presence of two or more risk factors strongly favors surgery.

Consider surgery	Consider conservative treatment
Large osteochondral fragment/loose body	Small flakes on the medial patellar border
Patella subluxed in transverse imaging, patellar tilt >20˚	Patella centralized in transverse imaging, patellar tilt <20˚
Dejour type B, C and D trochlear dysplasia	Dejour type A trochlea
Presence of J-sign and preexisting symptoms of instability	No previous symptom of instability
Genu valgum >10˚	Neutral or constitutional varus alignment
Femoral anteversion >30˚	Femoral anteversion <20˚
Syndromic joint hyperlaxity (Ehlers–Danlos, etc.) Beighton score >6	Beighton score <6
Patella alta (Caton index 1.3+)	Caton index 0.8–1.2
TT-TG distance >16 mm	TT-TG distance <16 mm
Contralateral patellar instability	Unilateral instability