Patella instability
What is Patella instability?
Patella instability occurs when the kneecap slips partly or completely out of the trochlear groove. It may follow a traumatic dislocation or be related to anatomy such as trochlear dysplasia, high-riding patella, limb alignment or ligament laxity.
Common symptoms
Patients describe the kneecap giving way, a visible dislocation, swelling after injury, pain around the front of the knee, apprehension with twisting and loss of confidence during sport or stairs.
Diagnosis and imaging
Assessment includes examination of patella tracking, apprehension, alignment and ligament laxity. X-rays and MRI assess cartilage injury, MPFL injury and loose bodies. CT may be used for detailed alignment and rotational planning in recurrent cases.
Non-surgical treatment
A first-time dislocation without major loose body or high-risk anatomy may be treated with bracing, swelling control and physiotherapy. Rehabilitation focuses on quadriceps, hip control, landing mechanics and confidence.
Surgical treatment
Surgery is considered for recurrent instability, high-risk anatomy, loose bodies or significant cartilage injury. Options include MPFL reconstruction, tibial tubercle osteotomy, trochleoplasty in selected cases, or combined procedures matched to the cause.
Recovery and follow-up
After stabilisation surgery, rehabilitation protects the reconstruction while restoring motion, strength and control. Return to pivoting sport requires objective strength, movement quality and confidence.
Patella instability FAQs
Will my kneecap dislocate again?
Risk depends on age, anatomy, injury pattern and rehabilitation. Recurrent instability is more likely when underlying risk factors are present.
How is patella instability diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
What is MPFL reconstruction?
It reconstructs the main soft-tissue restraint that helps stop the kneecap dislocating to the outside.
Will I need surgery for patella instability?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
When can I return to pivoting sport?
Return depends on the diagnosis, treatment type, tissue healing and the physical demands of the activity. The plan is usually staged, with strength, range of motion and confidence rebuilt before unrestricted loading.
Reconstructive Orthopaedics Melbourne (ROM)
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