Patello-Femoral Instability

Patello-femoral instability occurs when the kneecap (patella) moves abnormally or slips partially or completely out of its groove at the front of the knee.

This condition commonly affects young active individuals and athletes and may result in recurrent dislocations, pain and loss of confidence during sports and daily activities.

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