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.
Patellar instability occurs when the kneecap (patella) moves outside of its normal groove (trochlear groove) at the end of the thigh bone (femur). The patella normally slides up and down in this groove as the knee bends and straightens.
Patellar instability can occur as a single traumatic event or as chronic/recurrent instability. The two types of patellar instability include the following:
When the kneecap repeatedly slips out of position, it can cause pain, cartilage damage, and long-term knee problems.
Patellar instability is often caused by a traumatic injury, such as a direct blow to the knee or a sudden twisting movement that forces the kneecap out of alignment. However, several structural and lifestyle-related risk factors can also increase the likelihood of developing patellofemoral instability. Common causes and risk factors include:
Structural differences in the knee joint can make the kneecap more prone to instability. A shallow trochlear groove in the thigh bone, abnormal alignment of the shin bone, or an elevated tibial tubercle can reduce stability and increase the risk of patellar dislocation.
Weak quadriceps muscles can make it difficult to keep the patella properly aligned within the femoral groove. When the surrounding muscles are not strong enough, the kneecap may slip or shift during movement, leading to instability.
The medial patellofemoral ligament (MPFL) is one of the primary ligaments responsible for stabilizing the kneecap. When the medial patellofemoral ligament MPFL is stretched or torn — often during a first-time patellar dislocation — the kneecap becomes more vulnerable to chronic patellar instability.
Athletes and younger patients who participate in sports that involve jumping, cutting, or sudden direction changes — such as basketball, soccer, football, and gymnastics — face a higher risk of kneecap dislocation and patellar instability.
Patients who have experienced a complete dislocation are more likely to develop chronic patellar instability. Without proper treatment and physical therapy, the affected knee may continue to experience recurrent dislocations.
Repeated strain on the knee joint can weaken supporting structures such as the patellar tendon and surrounding ligaments. Over time, this may increase the risk of instability, particularly in active adults and individuals who perform repetitive knee movements.
Symptoms of patellar instability can vary depending on whether you experienced a first-time dislocation or chronic patellar instability. Common symptoms include:
Your doctor will begin by consulting your medical history and conducting a physical examination. The physical examination may involve walking around, straightening, and bending your leg. They may also gently feel around your kneecap to check for alignment.
The following imaging tests may also be ordered
Several conditions have overlapping symptoms with patellar instability. They can include the following:
Whether your kneecap has dislocated partially or fully, there are several treatment approaches to regain stability in your joint.
The first approach is to return the kneecap to the trochlear groove in a technique called reduction. Sometimes this happens on its own. However, if it hasn’t, the doctor will apply a gentle force to return the kneecap to its proper position.
Many patients who have had a first-time patellar dislocation can recover with nonsurgical treatments. Nonsurgical treatments for patella instability include the following:
Rest, ice, compression, and elevation (RICE) are often recommended for immediate relief of pain and swelling. Anti-inflammatory medications may also be prescribed.
Wearing a knee brace can provide additional support to the patella, especially during physical activity, reducing the risk of further patellar subluxation or dislocation.
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.
Surgery may be recommended for those with chronic patellar instability. It may also be recommended if there is damage to the soft tissue, such as loose cartilage fragments or ligament tears.
Surgical options may include the following:
If you’re dealing with knee pain or have experienced a patellar dislocation, our specialists at Precision Orthopaedic Specialties are here to help. With locations in Chardon, Chagrin Falls, and Middlefield, Ohio, our experienced team of knee specialists is ready to provide personalized care.
Schedule an appointment with us 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
Patellar instability often feels like the kneecap is slipping, shifting, or moving out of place. Many patients also experience knee pain, swelling, stiffness, or a catching or locking sensation, especially during walking, climbing stairs, or bending the knee.
Yes. Many first-time patellar dislocations can be treated successfully with nonsurgical treatments such as rest, ice, knee bracing, and physical therapy. Surgery is typically only recommended for patients with chronic patellar instability, recurrent dislocations, or structural abnormalities.
Patellar instability is commonly caused by traumatic injury, but it can also result from anatomical abnormalities, weak thigh muscles, loose ligaments, or previous kneecap dislocations. Athletes and younger patients are often at higher risk.
Recovery time varies depending on the severity of the injury. Many patients recover within several weeks to a few months with nonsurgical treatment and physical therapy. More complex cases or surgical treatment may require a longer recovery period.
You should see a doctor if you experience knee pain, swelling, difficulty walking, or a sensation that your kneecap is slipping out of place. Early diagnosis and treatment can help prevent long-term complications and reduce the risk of future dislocations.
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