Squinting patellae

Foot is straight but patella 'squints'...

Illustration of the lower limb from above showing the patella squinting inwards, despite the foot pointing forwards.

Implications of squinting patellae

A squinting patella usually implies a rotational deformity of one or both of the long bones - femur or tibia.

The anomaly may not cause symptoms, but sometimes leads to anterior knee pain.

"...In cases caused by a combined increased tibial external torsion and increased femoral internal torsion we are talking about the ‘inwardly pointing knee’ - syndrome...."

Jens Liße et al

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Management of the symptomatic squinting patella

Because the problem is usually due to rotation in the bones, physiotherapy may not prove useful, and the symptomatic patient may look to a surgical solution.

X-rays and scans will be needed to determine exactly where the rotation lies, and the problem may affect both femur and tibia.

Surgery will usually involve a de-rotation osteotomy.

"....isolated tibial or femoral torsional osteotomies showed a significant reduction of anterior knee pain and patellar instability...."