Patellofemoral instability usually presents with the patient having a sensation of their kneecap (patella) 'slipping away' or feeling loose on movement of the knee. This may be associated with pain in the anterior (front) of the knee and swelling.
Patellofemoral instability can be classified into two main groupings:
Primary Patellofemoral instability:
This type of instability can evolve from a number of different mechanisms, such as:
Lax or over-flexible ligaments around the knee
The location of the patella being too high within the knee joint (patella alta)
The tibial tuberosity may lie anatomically towards the outside (lateral) surface of the tibia.
Treatment of Primary Patellofemoral instability
Treatment
may be non-surgical or surgical
Non- Surgical:
If the knee is swollen and painful a knee extension brace can help to immobilize the knee.
Quadriceps strengthening, in particular of the VMO (vastus medialis obliquus) muscle, may be advised.
Patellar taping techniques may provide help in facilitating correct patellar tracking.
Surgical
In some cases surgery may be needed to correct the alignment of the patella. This may involve;
Lateral release of retinaculum and other muscle fibres
This condition results from a primary knee dislocation. The medial patellofemoral ligament is the main stabilizer of the patella in preventing the patella from shifting laterally. During a knee dislocation this structure may be severely compromised resulting in patellofemoral instability.
Treatment of patellofemoral instability
Non-surgical
The same treatment principles apply for secondary patellofemoral instability as they do for primary instability.
If the knee is swollen and painful a knee extension brace can help to immobilize the knee.
Quadriceps strengthening, in particular of the VMO (vastus medialis obliquus) muscle, may be advised.
Patellar taping techniques may provide help in facilitating correct patellar tracking.
Surgical
Repair of the medial patellar ligament may be necessary the structure is badly torn
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