Patellofemoral instability

Knee Instability – What is it?

knee brace

Knee Brace

In some patients , the kneecap (patella) has a tendency to disengage from it normal position and dislocate to one side. This can lead to instability and giving way, and patients can easily lose confidence in their knee. Commonly this is called knee instability.

This is often due to an abnormality in the way the front of the knee joint is made, and related to a shallow thochlea groove, small and high placed patella or due to abnormalities in the soft tissues and ligaments around the knee.  This is often called Patellofemoral dysplasia.

Occasionally, patella instability can occur in a knee with normal anatomy, following a twisting or sporting injury. This is called a “traumatic dislocation”.

Patella Instability Diagnosis

A careful history, clinical examination and a combination of special X-rays, CT scans and MRI scans will let your surgeon know exactly what is happening with your Patellofemoral joint.

Patella Instability Treatment

Patella instability is completely curable surgically with a combination of sports physiotherapy and surgical stabilisation

In the immediate setting, the kneecap needs to be gently relocated, and this is often done in the A&E setting.
In some cases, conservative treatment which includes Physiotherapy, hydrotherapy, taping and muscle building in the gym may treat the condition.

Often when the patella is recurrently unstable (ie. the kneecap feels unstable and repeatedly comes out of joint), surgery is required to repair the Medial Patellofemoral ligament (MPFL) along with contracture releases and bony realignment procedures (called a Tibial Tubercle Osteotomy).

The procedure that is required to correct recurrent instability of the patella depends on whether the instability is due to a “soft tissue” laxity, a bony mal-alignment issue, or a combined abnormality.

The necessary operation and rehabilitation thus varies from patient to patient and depending on the exact cause of the instability, and patients will have a personally tailored physiotherapy programme.

Mr. Rajaratnam has a particular interest in disorders of the Patellofemoral joint and has treated a number of patients with PFJ instability, and most get back to active sports with confidence.