This episode serves as a comprehensive educational guide for surgeons and medical trainees, focusing on the surgical management of patellofemoral instability. It outlines a tailored clinical algorithm that uses specific radiographic measurements and bony anatomy to determine whether a patient requires soft-tissue reconstruction or bony realignment procedures. The material emphasises precise surgical techniques, such as the correct placement of femoral tunnels and methods to avoid growth plate injuries in pediatric patients. Key topics include the indications for trochleoplasty and tibial tubercle osteotomy, as well as strategies for postoperative rehabilitation and return to sport. Additionally, the document provides structured  ...