Patellar Instability

Patellar instability presents with a range of symptoms that significantly impact daily life. Recurrent dislocation or subluxation of the kneecap is often accompanied by sensations of knee instability, causing pain, swelling, tenderness, and difficulty in performing basic knee movements such as walking, running, or climbing stairs. These symptoms can vary in intensity, with some individuals experiencing occasional episodes of instability and discomfort, while others may endure chronic pain and functional limitations that affect their ability to engage in physical activities or even perform routine tasks.

Patellar instability is multifactorial, stemming from various anatomical, biomechanical, and traumatic factors that disrupt the delicate balance of the patellofemoral joint. Anatomical abnormalities, such as a shallow or tilted patellar groove, predispose the patella to abnormal tracking and dislocation. Ligament laxity, particularly involving the medial patellofemoral ligament, and muscle imbalances further contribute to joint instability. Traumatic injuries, such as direct blows to the knee or sudden twisting movements, can also precipitate patellar instability by causing structural damage or stretching of the supporting ligaments and soft tissues.

Accurate diagnosis of patellar instability requires a comprehensive evaluation, beginning with a detailed medical history review to identify any predisposing factors or previous knee injuries. A thorough physical examination is then performed to assess patellar alignment, ligament integrity, muscle strength, and joint stability. Imaging studies, including X-rays and MRI scans, are essential for further evaluating structural abnormalities, identifying any underlying anatomical issues, and assessing the extent of soft tissue damage. These diagnostic tools help guide treatment decisions and determine the most appropriate management approach for each patient.

Treatment strategies aim to alleviate symptoms, restore stability, and improve function. Initially, conservative approaches such as physical therapy to strengthen surrounding muscles, bracing or taping to provide additional support, and activity modification may be employed. In cases of severe instability or failed conservative management, surgical intervention may be necessary. Surgical options may include procedures to address anatomical abnormalities, reconstruct damaged ligaments, or stabilize the patella through realignment surgeries, aiming to restore stability and enhance knee function.