Patellofemoral instability can be treated with high success rates. Medial patellofemoral ligament reconstruction is the first-line surgical treatment for patellofemoral instability. Trochleoplasty, tibial tubercle osteotomy, lateral retinacular release can be applied additionally. However, biomechanics of the patellofemoral joint and surgical techniques cause some complications. Most common of these complications are; recurrence of patellofemoral instability, loss of knee range of motion, patellar or tibial fracture, iatrogenic medial instability, patellofemoral arthrosis, chondrolysis and implant irritation. In oder to prevent complications, attention should be paid to selection of the appropriate femoral fixation points and their control during surgery, creation of bone tunnels with thinner drills which do not traverse the entire patella, avoidance of detaching bone fragments in tibial tubercle osteotomies, if possible, and early postoperative rehabilitation.