Visit us on the web:

     Patellar instability is a condition in which a person's knee cap or patella subluxes or moves in and out of it's normal resting position in the groove at the end of the femur. If it moves out too far and is no longer in contact with the groove in the femur it is called a dislocation. This condition usually occurs in childhood to young adulthood. Due to anatomical differences in the pelvis and hips females are more susceptible.

     Most cases of recurrent patellar subluxations or dislocations occur during sporting activities that involve twisting or rotation of the knee such as soccer or basketball. Other causes are direct trauma to the knee (falls or car accidents) or underlying anatomic factors such as misalignment of the patella in the groove, weak quadriceps muscles or congenital bony changes that causes incongruent positioning of the patella on the femur.

     Severe dislocations or subluxations that do not respond to conservative care may respond to surgery. Dislocations that do not self reduce will need a doctor to use gentle force to push patella back into place. Any bony or cartilage damage as result of the trauma may require arthroscopic surgery to correct. Surgery to correct patellar alignment or tracking may require changing how the muscles (quadriceps) pull on the patella by shifting it's bony attachment on the tibia or releasing the fibers that run along the outside of the patella that may be pulling it too much to the outside.

     Physical therapy is frequently used to conservatively to manage patellar instability. Exercises are prescribed to strengthen the (quadriceps and hamstrings) muscles around the thighs as well as the hip musculature. Manual therapy techniques are employed to stretch or mobilize tight tissue around the knee. Modification of jumping, landing, and squatting techniques will be addressed as well for the athletic population. In acute cases your therapist may need to use passive modalities such as ultrasound or electric stimulation to help manage pain or swelling. Bracing of the knee may also be recommended.

     Patellar instability is a condition that often responds favorably to conservative care. Severe cases will require surgery followed by post-operative therapy to help regain function and restore normal levels of activity in the future.

References

1) Web Md

2) Wikipedia

3) About.Com/Orthopedics

4) American Academy of Orthopedics

5) Sportsmd.com

6) KneePainInfo