Patellar instability is a condition that affects the stability of the knee cap, causing pain and limiting functionality. The patella is a small bone that plays a key role in the biomechanics of the knee, sliding along the femoral trochlea as the leg bends and stretches. When a problem occurs in this mechanism, the patella can undergo partial or total dislocation and consequently cause patellar instability.
The condition is more common in adolescents and young adults, and especially in athletes whose activities require rapid changes in direction, jumping or twisting movements. Without proper treatment, patellar instability can result in chronic pain, cartilage damage and an increased risk of early onset arthritis.
What causes patellar instability?
Patellar instability results from a combination of endogenous and exogenous factors that compromise the stability of this particular bone. Such factors may include:
- Anatomical abnormalities. Conditions such as external femoral condyle hypoplasia or high patella position make it easier for the patella to slip out of position. They also reduce the ability of the knee cap to stay in place during strenuous activities.
- Relaxation and weakness of the ligaments and muscles around the knee. If damaged by any cause, they no longer provide the necessary stability and increase the risk of instability.
- Injury, such as a direct hit to the knee or twisting during sports activities, which make the knee more vulnerable to repeated instability.
- Seldom overuse and repetitive strain, especially for athletes and people whose daily routine or nature of work involves repetitive knee movements.
The symptoms that accompany patellar instability
The symptoms of the condition vary in severity depending on whether the instability is acute or chronic. The most common symptoms are:
- Pain around the knee cap, especially during activities such as sitting, climbing stairs or running.
- a feeling of instability as if the knee is 'giving way', especially during rotation or weight-bearing activities.
- swelling and tenderness around the knee, especially in acute dislocations
- limited mobility, stiffness or difficulty in fully bending or straightening the knee, especially in chronic cases
- Visible deformity, usually on the sides upon dislocation.
To diagnose patellar instability, a medical history of injuries and symptoms, clinical examination and imaging tests such as x-rays (to evaluate bone alignment and identify any anatomical abnormalities), or MRI (for detailed images of soft tissue) are necessary.
How is patellar instability treated?
The way in which patellar instability is treated depends on its severity, the underlying causes and the patient's activity level. It may involve both conservative and surgical methods.
Conservative treatment methods aim to restore stability and improve knee function without surgery. They may include:
- A physical therapy program with exercises to strengthen the quadriceps muscles and correct muscle imbalances of the knee and hip.
- Stabilization of the patella with a special patella shin especially during activities.
- Rest and reduction or avoidance of movements that put a strain on the tissues.
For more serious cases such as recurrent instability or severe anatomical anomalies (such as trochlear dysplasia), the solution is usually surgery to reposition the patella, reconstruct the torn ligaments and/or trochleoplasty), using an appropriate technique, depending on the extent of the damage and the patient's level of activity.
Can patellar instability be prevented?
Patellar instability can be prevented by treating the factors that cause it and also by:
- Strengthening exercises of the quadriceps and hip muscles
- Correct technique in landings and rotation mechanics to minimize pressure on the knee.
- Use of supportive equipment during high-risk activities.
- Maintaining a healthy weight in order to reduce pressure on the knee joint and therefore the risk of injury.
To find out more about patellar instability, contact us at 6943903343 (secretariat) or 6949196061 (doctor) and at orthopedikos-papagiannopoulos.gr and make an appointment.
