The patello-femoral joint :
maltracking pattela - - Posted by corry (corry), 6 November 2004
had orthoscopic surgery 4 weeks ago.found out i have tracking problem.doc said he clened under pattela but pattela was in baD shape.i still have same symptoms as before surgery,doc told me to try 4 weeks of exercise to see if this would help.i have 2 more weeks to go and no improvemnet.what else may he do to fix this.
Posted by nmcbride (nmcbride), 7 November 2004
Corry,
There are a few surgical options for correcting maltracking of the patella, I think the most common one is a TTT (Tibial Tubercle Transfer), ask your OS about this, it may or may not be an option for you, obviously your OS would have to talk this over with you, in the meantime you could maybe try wearing a brace or taping to help alleviate some of the pain. Good luck.
Natalie.
Posted by kporterjud (kporterjud), 24 November 2004
Just out of curiosity what does a maltracking patella feel like? I'm concerned because my left knee gives me some pretty strange sensations going up or down stairs, walking uphill or sometimes just standing for a long period of time. And the sensation seems to be just under the patella. (Like I don't have enough problems with my right knee.)
Posted by corry (corry), 24 November 2004
i get a sharp pain behinde the kneecap when going up and down stairs or squatting.its okay when walking,i to am having problems with other knee doc told me from overcompensating.
Posted by kporterjud (kporterjud), 24 November 2004
Mine is sometimes painful, but it feels more like it's jumping around.... (Yech!)
Posted by mhsflute07 (mhsflute07), 25 November 2004
Both my kneecaps maltrack to the point of dislocation. They sublux constantly. I guess the way I would describe it is it feels like the kneecaps are sliding laterally, toward the outside of the leg. I often get a grinding sensation on the lateral side too. Dislocations cause excutiating pain and are completely debilitating. I would try a brace and taping might help too.
~Erin~
Posted by kporterjud (kporterjud), 25 November 2004
are there patella-specific braces?
Posted by kneesknees (kneesknees), 26 November 2004
on 11/25/04 at 02:31:52, mhsflute07 wrote:I guess the way I would describe it is it feels like the kneecaps are sliding laterally, toward the outside of the leg.
Hi, I hope you don't mind me jumping in, but I just wondered if its possible for the patella to be too far towards the inside of the leg rather than the outside because that is exactly what my right kneecap feels like.
I've only ever seen people talking about the patella maltracking towards the outside of the leg, but can this happen in the opposite direction?
Thanx everyone and sorry again for jumping in 
Posted by shadehawk (shadehawk), 26 November 2004
Yes, they are called "squinting patellae". When standing with knees pointing forward, feet stick out like a duck and when feet point straight ahead, knees almost touch or sit medially. This means you have tibial torsion.
Quite a few of us on this site have the same problem.
Do you also have a hypermobile patella, flat foot or feet. This is called "Miserable Malalignment".
Posted by kneesknees (kneesknees), 27 November 2004
Thanks for the reply shadehawk, I'd read about miserable malalignment before and it does sound (and look) exactly like what I have.
Its only in my right knee/leg though, my left leg is only very slightly turned inwards.
I have actually had to have inner soles for my shoes before because of pain in my feet and have very high arches rather than flat feet. Would this mean that I may not have miserable malalignment at all?
Thanx for your help 
Katy
Posted by shadehawk (shadehawk), 27 November 2004
Katy, I think if you Google search you will see that high arches is also part of miserable malalignment syndrome.
I also wear orthotics, but they do not seem to be helping my knee pain much, have you found any relief with them?
Posted by kneesknees (kneesknees), 27 November 2004
Wow thanks for replying so quickly.
I actually had the inner soles before I experienced any problems with my knees - they were meant to relieve the pain I was experiencing in the arches of my feet which I think they probably did help with.
Its interesting that high arches can also be associated - I will definately go and Google that now.
Thanx again Shadehawk and I hope that your knees are not feeling too bad
Posted by lilrosie06 (lilrosie06), 26 January 2005
Hi Corry....
I know that this post was made a couple of months ago, but I think I may have a tracking problem also. Can you tell me more? When I bend my knee, like when I am sitting, or try and bend it certain ways lying down, or doing stairs, I get this feeling that something is like slipping in my knee. Usually towards the outside. It feels really weird. I have been trying to describe it to the OS. My MRI appeared normal, and I started PT today for 3 weeks. If I dont feel better, then he will scope it. Did you have an MRI? If so, did it show on there? Please give me any information you can. AGain, sorry this is in response to an old post. I just learned about the site. Thanks.
Donna
Posted by shadehawk (shadehawk), 26 January 2005
I think that you can tell about mal-tracking with a CT scan (correct me if I am wrong) if they bend you knee at 30, 60 and 90 degree angles and this will show your mal-tracking. Do not think this will show up on an MRI machine unless they use the open style MRI where they can bend your knees at the above noted angles. There are also some weight-bearing x-rays that will show mal-tracking problems....
You need to see an OS who specializes in knees for a thorough inspection of your knees. There is a list on the top of this page 'knee surgeons'.
Good luck. 
Posted by dubbin (dubbin), 26 January 2005
I think I have maltraking, too. That "sliding" sounds VERY familiar!
Anyway- I was wondering when does it get to surgery? I know they'll try PT 1st and all that, but I mean is it only successful when it's severe? Is surgery successful ever for this, or do you just have to deal with it?
Thank you!
Posted by lilrosie06 (lilrosie06), 26 January 2005
I was wondering that myself. My OS actually never mentioned a tracking problem. But, after reading about it, and relating it to my symptoms, I am almost positive that is whats going on. And thinking about several comments my physical therapist made to me about strengthening the quads, etc., I believe he thinks this is my problem also. I explained to him what my knee does, and he said that everything is tight in there and loosening it up should correct that. BUT....after therapy, when it was all loose, I was still feeling it. I guess if it has to be scoped, the OS will be able to see things better in there. I sure hope so. I feel so unsteady...like my knee is gonna give out on me all the time. That is because of the moving feeling. I guess time will tell. But its good to know others have experienced the same thing, because its all very frightening. Thanks again for all the comments and support. Keep them coming....
DONNA
Posted by shadehawk (shadehawk), 26 January 2005
Hi Dubbin,
I believe that there has to be a combination of things wrong with your knees before an OS decides to do surgery. Open surgery is a major surgery and they do not do this unless all else has failed.
You need to have mal-alignment, mal-tracking, severe pain, dislocations or subluxations, hypermobile patellae, etc. etc. PT works on 85% of the population. That is quite a high percentage when you think about it.
It is really best to try very hard to do therapy (PT) and if your PT does not work with you individually then find one that does this. Usually you do PT for over 6 or 7 months to see if it will help your condition before a surgeon ever considers surgery.
Find an OS that specializes in knees like the ones listed on the top of this page. There might be one of them in your area.
Good luck to you.
Posted by dubbin (dubbin), 26 January 2005
I'm not trying to self diagnos, thank you for the warning though. But I've had knee problems since I was 8 months old so I'm sick of it. And the Dr's I've seen won't even discuss what could be wrong, they just send me to PT, which yes I did do. So I'm tired of it, the x-rays, the MRI's, the appointments, the braces, PT, taping, I just want someone to tell me what is wrong and what my options are.
My husband keeps telling me to look into the surgery (not a knee person, doesn't understand that there might not be one/ don't qualify/ might not help). But it got me thinking and I wanted to ask a few questions.
And no, I'm sorry, I won't do PT again unless a dr wants to tell me exactly why I'm doing it. They taped my knees for 6 weeks and I won't ever do that again.
Not to mention, I don't have a sports injury or an accident or anything like that, so all this PT is not covered by health insurance. Which meens that at $150 a session (I can't remember exactly how much it was) I was going 3x a week for 6 weeks- figure that amount out. So a few months of PT isn't an option unless I get some answers first.
.............
I'm sorry, bad day.... It's just that it's getting worse, and the weather isn't helping. And I have to start the whole procedure over again with a new DR and get a 3rd opinion now.... It's just rough to think of all the appointments... going through history again...
I'm just venting... worn out is all... sorry
Posted by shadehawk (shadehawk), 26 January 2005
Hey, I understand what you are saying. Can't they just teach you the exercises and you do the exercises at home. That is what alot of people do....
I know the frustration, I am also in that category myself it is like pounding your head into a brick wall sometimes...maybe you are having the same problem as I am..not being able to find an OS that offers the kind of procedures that you need.
This is always a possibility! Weather changes are awful for my knees also. You have to just keep trying.
Updated Thu Aug 21 2008