Patella Instability

The patella sits in a groove at the end of the thigh bone (femur) and moves up and down in its groove as the knee bends and straightens. When this movement becomes abnormal, or if the kneecap dislocates entirely, it leads to instability. Some individuals experience chronic patellar instability, where the kneecap repeatedly slips out of place, while others may only experience a single episode due to an injury. Dr. David Gazzaniga at Newport Orthopedic Institute in Orange County, California specializes in diagnosing and managing this condition, offering tailored treatment plans based on each patient’s specific needs.

Patellar instability can result from various factors, including injury, structural abnormalities, and muscle imbalances.

• One of the most common causes is a traumatic dislocation, which typically occurs during sports or activities that involve sudden twisting, jumping, or direct impact on the knee. This type of injury can damage the ligaments and soft tissues that help keep the patella in place, leading to ongoing instability.
• Another contributing factor is anatomical variation, where some individuals are born with shallow or misshapen femoral grooves, making it easier for the patella to shift out of position.
• Additionally, ligament laxity (loose ligaments) can increase the risk of instability, especially in individuals with connective tissue disorders.
• Muscle imbalances also play a significant role in patellar instability. Weakness in the quadriceps can reduce the stability of the patella and make it more likely to shift. David Gazzaniga and his team at Newport Orthopedic Institute carefully assess each patient’s muscle strength, joint alignment, and movement patterns to determine the root cause of instability.

Patients with patellar instability often experience a variety of symptoms that range from mild discomfort to severe pain and mobility issues.

• A feeling of the kneecap “giving way” is one of the most common complaints, as instability can make it difficult to trust the knee during movement.
• Many individuals also report recurrent episodes of partial dislocation (subluxation) or full dislocation, which can cause sudden pain and an obvious change in the shape of the knee.
• Swelling and pain around the front of the knee (anterior knee pain) are also common, especially after physical activity or prolonged sitting with the knee bent.
• Some patients may hear a popping or clicking sound when moving their knee, which can indicate abnormal patellar tracking. In more severe cases, the knee may become stiff or locked, making it difficult to straighten or bend fully.

If left untreated, chronic patellar instability can lead to cartilage damage and early arthritis, increasing long-term knee pain and reducing mobility. Seeking care from an expert like Dr. David Gazzaniga at Newport Orthopedic Institute can help prevent complications and restore knee function.

Diagnosing patellar instability requires a thorough evaluation by an experienced orthopedic specialist. At Newport Orthopedic Institute, Dr. David Gazzaniga performs a comprehensive assessment that includes a review of the patient’s medical history, a physical examination, and imaging tests to determine the extent of the instability.

• During the physical examination, Gazzaniga will assess knee alignment, range of motion, and muscle strength. He may perform specific tests to check for laxity in the ligaments and observe how the patella moves when the knee bends and straightens. Patients who have had previous dislocations may show signs of looseness in the supporting structures around the kneecap.
• Imaging studies such as X-rays help evaluate bone structure and identify any anatomical variations that contribute to instability. MRI scans provide a more detailed look at the soft tissues, including ligaments, cartilage, and muscle attachments, which can help determine if any damage has occurred following a dislocation. In some cases, a CT scan may be used to create a 3D image of the knee, allowing for a precise assessment of patellar alignment and bony abnormalities.