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The unstable kneecap (forum discussions and other resources)

The unstable kneecap
The unstable kneecap
© KNEEguru

In this paper, I have gathered together several papers and discussions about patellar instability from this site that may be useful to readers, and save them the time of combing through the site looking for answers.

General discussions about patellar instability

mri report help pls - acute patellar dislocation

Recurrent Patellar Dislocation

new to board - trochlea dysplasia and patella alta

Told i'm inoperable but finding it hard to accept. Might a trochleoplasty work?

patellofemoral dislocation and instability treatment options

trochlear dysplasia......i dont think im getting the right op :/

Specific procedures for patellar instability

Recurrent Dislocation MPFL Reconstruction (3/20/14)

Osteotomy for patellar instability (section 3 of a course on realignment osteotomy)

Trochleoplasty yes or no?

Arthroscopic deepening trochleoplasty

Smillie's LPFL reconstruction May 9 '11 - a diary

Finding the right help for patellar instability

Who's Who in patellofemoral surgery?

Please help me find a doctor that practices trochleoplasties

Treatment of Patella luxation in Denmark

 

Explanatory notes to help with context -

Instability of the kneecap (patella) includes -

  • patellar subluxation - episodes where the patella rides up the side of the grove in which it normally glides, giving a sudden sharp pain and possibly a giving way of the knee - but then the patella returns to its normal position.
  • patellar dislocation - an episode where the patella slips right out over the edge of its underlying groove, and gets stuck there - creating temporarily a very painful and deformed-looking knee until the kneecap is returned manually to its proper position. Usually there has been some incident with abnormal forces being applied suddenly to the patellar area, and there may be some internal tissue damage resulting from the incident.
  • recurrent patellar dislocation - when patellar dislocation occurs commonly with very little force being applied to the patella.

There are two main groups of causes -

  • an accident with abnormally high forces being applied to the knee, where the abnormal patellar movement is a result of the damage to the structures that normally keep it stable (such as the MPFL - medial patello-femoral ligament).
  • an underlying structural abnormality, existing prior to the first incident, and pre-disposing to instability. This includes the conditions of patellar dysplasia (an abnormally-shaped patella), trochlear dysplasia (an abnormally shaped groove) or patella alta (an abnormally high patella).

Correct management depends upon the underlying cause, and really one should seek advice from a surgeon who has particular expertise in the management of this region. Major problems can result from an incorrect assessment of the cause, with inappropriate surgery, which in some cases can aggravate the instability and make definitive management more difficult.

Updated: 11 Jul, 2014
ABOUT THE AUTHOR

Dr Sheila Strover

Clinical Editor
Degrees: 
BSc (Hons)
MB BCh
MBA

Dr Sheila Strover is the founder of the KNEEguru website. Although not a knee surgeon, she has a sound understanding of knee surgery and...

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