Dr. Adolph Lombardi Jr.
Hip, Knee
Patellar Instability
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Patellar instability occurs when the kneecap (patella) moves out of its normal position in the knee joint. Left untreated, patellar instability can lead to recurrent issues and long-term damage to the cartilage surface.
At JIS Orthopedics, located in New Albany and St. Clairsville, Ohio, our team specializes in treating knee conditions like patellar instability. Contact us today to schedule a consultation!
What Are the Signs of Patellar Instability?
The most obvious sign of patellar instability is the sensation that your kneecap is slipping out of place or has dislocated. Other signs and symptoms may include:
- Pain in the front of the knee, particularly around or behind the kneecap
- Swelling and stiffness in the knee joint
- Difficulty bending or straightening the knee
- A popping or snapping sensation when the kneecap moves
- In cases of patellar dislocation, you may see visible deformity in the knee
These symptoms can vary in severity depending on whether the kneecap has partially or completely dislocated.
Causes and Risk Factors
Patellar instability can have several causes. Some people are naturally predisposed to the condition due to the anatomy of their knee. Common causes and risk factors include:
- Shallow trochlear groove: The groove in the femur where the patella sits can be too shallow, making it easier for the kneecap to slip out.
- Weak or stretched ligaments: The medial patellofemoral ligament (MPFL) helps hold the kneecap in place, and if it is weakened or torn, instability can occur.
- Previous injuries: A history of patellar dislocations or injuries can weaken the structures of the knee, increasing the risk of chronic patellar instability.
- Misaligned or high-riding patella (patella alta): If the kneecap sits too high or is misaligned, it may not fit properly in the groove, leading to instability.
- High-impact sports: Activities like soccer, basketball, and gymnastics, which involve a lot of sudden movements, can increase the risk of injury.
- Genetics: Some people are born with structural differences in the knee that make them more prone to patellar instability.
How is Patellar Instability Diagnosed?
Diagnosis typically begins with a physical exam, during which the doctor will check the knee’s range of motion and feel for any signs of instability. Imaging tests, such as X-rays, MRI, or CT scans, are often used to get a clearer view of the knee structure and assess any damage.
An MRI can be particularly useful for assessing injuries to the medial patellofemoral ligament or other soft tissues, while a CT scan can help show the shape of the trochlear groove and whether any bone abnormalities are contributing to the problem.
Treatment for Patellar Instability
Treatment options for patellar instability depend on the severity of the condition and the frequency of dislocations. Non-surgical treatments are usually the first line of defense, especially if it’s the first occurrence of a dislocated kneecap. Common treatments include:
- Physical therapy: Strengthening the muscles around the knee, particularly the quadriceps, can help stabilize the patella and prevent further dislocations.
- Knee brace or taping: A knee brace can help keep the kneecap in place during movement, particularly during sports activities.
- Medications: Anti-inflammatory drugs may help manage pain and swelling.
For recurrent patellar instability, surgical intervention might be necessary. Surgical options include:
- MPFL reconstruction: If the medial patellofemoral ligament is torn, it may need to be surgically repaired or reconstructed to stabilize the kneecap.
- Trochleoplasty: In some cases, surgery to reshape the trochlear groove is performed to better accommodate the patella.
- Realignment procedures: If the kneecap is misaligned, surgical realignment of the patellar tendon or other structures may be required.
Can Patellar Instability Be Prevented?
While not all causes of patellar instability can be prevented, you can reduce the risk with proper care and strengthening exercises. Strengthening the quadriceps and other supporting muscles around the knee can provide better stability. Wearing a knee brace during high-risk activities, especially after an injury, can also help prevent recurrence.
Maintaining flexibility through stretching and avoiding movements that put undue stress on the knee can further minimize risk.
When to Call a Doctor
You should call a doctor if you experience any of the following:
- A dislocated kneecap that does not go back into place
- Persistent pain or swelling in the knee despite rest
- Recurrent episodes of your kneecap slipping out of place
- Difficulty moving the knee or bearing weight on it
Addressing patellar instability early can help prevent long-term damage to the knee. If you’re dealing with recurrent instability or are concerned about a knee injury, JIS Orthopedics can provide expert care.
Get Help with Your Knee Health
If you’re experiencing symptoms of patellar instability, don’t wait. At JIS Orthopedics, we specialize in diagnosing and treating conditions like patellar instability, ensuring our patients in New Albany and St. Clairsville, OH, regain full mobility and get back to their favorite activities. Schedule a consultation with one of our orthopedic specialists today!
Medically reviewed by Dr. Nicholas Walla
Sources
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/patellar-instability
- https://my.clevelandclinic.org/health/diseases/21571-patellar-instability
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5508303/#:~:text=While%20patella%20alta%20frequently%20plays,critical%20role%20in%20patellar%20stability.
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