68 patients with recurrent patellar instability and/or dislocation were randomized to one of three combinations of surgical interventions: medial patellofemoral ligament (MPFL) reconstruction plus lateral patellar retinaculum (LPR) release, MPFL reconstruction plus medial patellar retinaculum (MPR) plication, or LPR release plus MPR plication. Patients were followed up over 24 months postoperative for congruence angle, the patellar tilt angle, and the lateral patellofemoral angle on radiograph, patellofemoral joint congruence on CT, and clinical score on the Lysholm score, the Kujala patellorfemoral score, and the International Knee Documentation Committee (IKDC) score. While radiographic results did not significantly differ between groups, significant differences between the three groups were observed for joint congruence and clinical scores, all favouring the group which underwent MPFL reconstruction plus LPR release.