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Objectives 1. To discuss the regional differences in the use of concurrent procedures for the surgical management of patellofemoral instability 2. To understand the current indications for and controversies around tibial tubercle osteotomy for the treatment of patellofemoral instability and arthritis. 3. To understand the current indications for and controversies around trochleoplasty for the treatment of patellofemoral instability. 4. To understand the current indications for and controversies around rotational osteotomies of the femur and tibia for the treatment of patellofemoral instability 5. To consider a global approach to patellofemoral education 6. To explore future technologies and concepts that will help resolve the controversies discussed.