Misalignment of the kneecap in the femoral groove.
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Patellofemoral Instability
Patellofemoral instability occurs when the kneecap slips out of its normal position in the femoral groove. It can cause pain, swelling, and a feeling that the knee is out of place. Treatment may include strengthening exercises, splints, or surgery.
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The knee has three compartments: the patellofemoral, medial, and lateral. Patellofemoral instability means the kneecap (patella) moves out of its normal alignment, which can damage the soft tissues and ligaments that hold the knee in place. Instability occurs when the patella partially (subluxation) or completely (dislocation) moves out of its groove.
Causes and Symptoms
Causes of this instability can include anatomical defects, a high Q angle (the angle between the hips and knees), patellofemoral arthritis, and improper muscle balance. Young, active individuals in sports are more prone to this condition. Symptoms include pain when standing from a sitting position, a feeling that the knee may buckle or give way, and if the kneecap slips, you may experience severe pain, swelling, bruising, visible deformity, and numbness or partial paralysis below the dislocation.
Diagnosis and Treatment
Diagnosis is based on medical history, a physical exam, and diagnostic tests like X-rays, MRI, and CT scans. Conservative, non-surgical treatment for a partial dislocation may include pain medications, rest, ice, physical therapy, and knee bracing. If the kneecap is completely dislocated, a doctor may need to reposition it, a process called closed reduction. Surgery may be needed if non-surgical treatments fail, with the goal of realigning the kneecap and decreasing the Q angle.