Patello-Femoral Instability

What Causes Patellar Instability?

Several factors can contribute to kneecap instability, including:

• Previous patellar dislocation
• Shallow femoral groove (Trochlear Dysplasia)
• Ligament injuries
• Knock knees (Increased Q-angle)
• High riding patella (Patella Alta)
• Muscle imbalance and weak quadriceps
• Flat feet or abnormal lower limb alignment

Often, more than one factor may be present.

Common Symptoms of Patello-Femoral Instability

Patients may experience:

• Knee giving way or buckling
• Recurrent kneecap dislocations
• Pain at the front of the knee
• Swelling after sporting activities
• Clicking or catching sensations
• Fear of twisting or pivoting movements

Many patients describe the feeling that their kneecap is “slipping out” during activity.

How is Patello-Femoral Instability Diagnosed?

Diagnosis is based on:

• Detailed clinical examination
• X-rays
• MRI scan
• CT scan and 3D assessment in selected patients

These investigations help identify the underlying causes and guide treatment planning.

Non-Surgical Treatments for Patello-Femoral Instability

Patients with first-time dislocations or mild instability often improve with:

• Activity modification
• Physiotherapy
• Quadriceps strengthening
• Patellar taping or bracing
• Sports rehabilitation programmes

The goal is to improve patellar tracking and restore knee stability.

When is Surgery Recommended?

Surgery may be advised when:

• Dislocations keep recurring
• Instability affects sports participation
• There is associated cartilage damage
• Physiotherapy fails to control symptoms
• Significant anatomical abnormalities are present

Modern Surgical Treatment Options

Treatment is tailored to the individual patient and may include:

Arthroscopic Assessment and Cartilage Treatment

Treatment of associated cartilage injuries and loose bodies.

MPFL Reconstruction

Reconstruction of the Medial Patello-Femoral Ligament (MPFL), the most commonly injured stabilising ligament after patellar dislocation.

Tibial Tubercle Transfer (TTT)

Correction of abnormal patellar alignment in selected patients.

Trochleoplasty

Reserved for severe cases with a shallow femoral groove.

Many procedures can be performed using minimally invasive or arthroscopic techniques.

Recovery After Surgery

Typical recovery includes:

• Knee brace support for 4–6 weeks
• Physiotherapy to restore movement and strength
• Return to daily activities in 6–8 weeks
• Return to sports in approximately 4–6 months

A structured rehabilitation programme is essential for successful outcomes.

Why Early Treatment Matters

Untreated patellar instability may lead to:

• Recurrent dislocations
• Cartilage damage
• Patello-femoral arthritis
• Reduced sporting performance
• Long-term knee pain

Early diagnosis and treatment help protect the knee and improve long-term outcomes.

Why Choose Dr Anand Jadhav?

Dr Anand Jadhav specialises in:

• Patellar Instability Surgery
• MPFL Reconstruction
• Sports Knee Injuries
• Knee Arthroscopy
• Joint Preservation Surgery

His Aim is Simple