The patella (knee cap) is the small bone that forms the front of the knee. The patella is held in place by flexible ligaments, muscles and its shape, allowing it to move within the groove at the bottom of the femur bone. This range of movement allows us to perform everyday activities, such as walking, bending or reaching.
The ligaments, muscles and cartilage can be damaged or become misaligned over time, causing patella instability.
Also, when the surrounding ligaments suffer damage, the patella can slip from the groove in the femur, causing patella dislocation. The dislocation of the patella can cause further damage to the surrounding soft tissue, rendering it unable to stabilise the patella in the joint, also resulting in patella instability.
Causes of Patella Instability
Patella Instability can commonly arise due to:
- Traumatic injury causing dislocation such as a fall or a sporting injury
- Alignment issues, such as the shape of the hips, and the angle between the knees and the hips which may cause misalignment or malalignment
- Muscle weakness in the legs and hips
Patella Instability Symptoms
Signs and symptoms of patella instability may include:
- The feeling of weakness in the knees – feeling unsteady when you stand, and the need to be cautious when attempting to move normally
- Feeling pain when any knee movement is made, especially when pushing upwards from the knee, for example when standing up
- Repeated dislocation of the patella – this may reoccur several times
- Swelling of the knee
- Surface deformity and bruising
- Numbness in the knee area
- Inability to move the knee at all (especially after dislocation occurs)
Diagnosis of Patella Instability
Mr Soong Chua can diagnose patella instability with the use of a complete history, physical examinations, observing your range of movement and monitoring any response to special tests and initial treatments.
In order to confirm the severity of the patella instability, MRI or CT scans may be needed. These scans can be done at an X-Ray clinic by a radiologist. Mr Soong Chua will then produce a treatment plan, based on the information that the scan provide.
Patella Instability Treatment Options
Patella instability treatments will differ depending on the severity of the case, and the general health of the individual.
Less severe cases may require non-surgical treatment methods. This may include working with a physiotherapist or a podiatrist on a specialised recovery program. Pain management may also be required, often utilising over-the-counter pain medications.
However, some cases of patella instability may require patella stabilisation surgery. The type of patella stabilisation surgery that is performed will depend on the condition of the knee but ultimately, the goal for any orthopaedic intervention is to make the surrounding ligaments stable again, to allow the patella to move safely and freely, while remaining in the femoral groove.