Patellar Instability

Patellar instability is a condition where the kneecap slips out of its normal position, leading to pain and potential long-term damage to the knee joint. Understanding its causes, symptoms, and treatment options can help individuals manage this condition and reduce the risk of future dislocations.

Contact our team at Precision Orthopaedic Specialties in Northeast Ohio today for help resolving any issues you may have with your knees.

What is Patellar Instability?

Patellar instability occurs when the kneecap does not stay securely within the groove of the thigh bone (the trochlear groove). This instability can result in the patella shifting partially (patellar subluxation) or completely out of place (patellar dislocation). When the kneecap dislocates, it can be painful and may lead to further complications, such as damage to the cartilage, tendons, or ligaments surrounding the knee joint.

Patellar instability can be an occasional occurrence or, in some cases, become chronic, leading to repeated dislocations (recurrent dislocations). Chronic patellar instability significantly impacts an individual’s ability to engage in sports or even daily activities due to discomfort and the risk of repeated injury.

A man experiencing pain in his knee as a symptom of patellar instability in Chardon, Ohio.

What Are the Causes and Risk Factors of Patellar Instability?

Patellar instability is often the result of a traumatic injury, such as a blow to the knee or a sudden twisting motion that forces the kneecap out of alignment. Some of the most common causes and risk factors include:

  • Anatomical Abnormalities: Individuals with a shallow trochlear groove are at greater risk of patellar dislocation because the kneecap is less secure.
  • Weak Muscles: Weakness in the thigh muscles (quadriceps) can contribute to instability, as the muscles are less capable of holding the patella in place.
  • Loose Ligaments: The medial patellofemoral ligament (MPFL) plays a key role in stabilizing the kneecap. When this ligament is stretched or torn, usually due to a traumatic patellar dislocation, it can increase the likelihood of recurrent dislocations.
  • High-impact Sports: Student athletes involved in sports that require frequent jumping, pivoting, or quick direction changes—like basketball, soccer, or gymnastics—are at a higher risk of developing patellar instability.
  • Previous Injuries: A history of traumatic patellar dislocation significantly raises the chances of future dislocations, especially if proper rehabilitation is not followed.
  • Overuse: Continuous strain on the knee joint, often seen in active adults aged 35-55, can weaken the patellar tendon, increasing the risk of instability.

What Are the Signs of Patellar Instability?

Recognizing the symptoms of patellar instability is important for timely intervention. Signs may vary depending on the severity of the condition, but some common indicators include:

How is Patellar Instability Diagnosed?

Diagnosing patellar instability requires a thorough examination by knee specialists who will assess your medical history, symptoms, and activity level. The diagnosis process typically involves:

  • Physical Examination: Your orthopedic specialist will check for signs of instability by moving the kneecap and evaluating its alignment. They will also assess muscle strength and joint flexibility.
  • Imaging Tests: X-rays, MRIs, or CT scans may be used to get a clear view of the knee’s anatomy and detect damage to ligaments, cartilage, or bones. These tests help determine whether the trochlear groove is shallow, whether there is a tear in the medial patellofemoral ligament, or if the patellar tendon has been damaged.

Patellar Instability Treatment

Treatment for patellar instability depends on the severity of the condition and the patient’s activity level. Options include:

Physical Therapy

A tailored physical therapy program focuses on strengthening the muscles around the knee, particularly the quadriceps, to improve stability and prevent future dislocations. Therapy also helps restore range of motion and reduce pain.

Knee Brace

Wearing a knee brace can provide additional support to the patella, especially during physical activity, reducing the risk of further patellar subluxation or dislocation.

Non-Surgical Management

Rest, ice, compression, and elevation (RICE) are often recommended for immediate relief of pain and swelling. Anti-inflammatory medications may also be prescribed.

Surgical Intervention

In severe cases, particularly with recurrent dislocations or chronic patellar instability, surgery may be necessary. Procedures may involve realigning the patella, repairing or reconstructing the medial patellofemoral ligament, or reshaping the trochlear groove.

Take Control of Your Knee Health with Precision Orthopaedic Specialties

If you’re dealing with knee pain or have experienced a patellar dislocation, the specialists at Precision Orthopaedic Specialties are here to help. With locations in Chardon, Chagrin Falls, Middlefield, and Geneva, Ohio, our experienced team of knee specialists is ready to provide personalized care.

Schedule an appointment with Precision Orthopaedic Specialties today! Let us help you get back to doing the activities you love with confidence.

Medically reviewed by Albert S.M. Dunn, D.O., FAAOS