With patella subluxation, the kneecap is not moving in a groove on the top of the femur properly. Patella subluxation, or malalignment is a common cause of pain in the front of your knee.
The patella or the kneecap serves an important function. The patella serves as an attachment point for the quadriceps and patella tendons. The patella enables us to straighten our knee with little effort. The patella sits in a groove on the front of the thigh bone. Patella subluxation is a form of patella mal-tracking or instability. If the patella does not sit properly in the groove on the thigh bone, then patella subluxation exists.
What Is Patella Subluxation?
Patella subluxation exists if the patella is trying to slide out of the groove. Normally the patella sits evenly in the groove on the femur. As seen in the picture below, in patients with patella subluxation the patella or kneecap is tilting out of the groove.
When the patella slides out of the groove it creates a situation where the cartilage on the bottom of the patella, and the groove are not contacting each other evenly. The outer part of the cartilage on the kneecap is under higher pressure because of the subluxation. If this situation persists, then the cartilage under the patella starts to wear and causes significant inflammation and eventual patella osteoarthritis.
Patients with patella subluxation feel pain in the front of the knee. The pain is typically increased with stair climbing, and arising out of a chair. Some of you may feel the patella clunk back into place as you bend the knee. The causes of patella subluxation are complex and numerous. It can be due to a muscle imbalance, it can be due to your bones not forming properly when you were a baby and it can be due to a previous history of trauma or a patella dislocation.
How Do I Treat Patella Subluxation?
In mild cases, a simple knee compression sleeve can alleviate much of the pain associated with patella malalignment.
Specific patella stabilization braces can assist you in minimizing pain and controlling your patella tracking. Bracing to help your patella track more normally is really only achievable for thinner legs. The more prominent your kneecap is, the higher the likelihood the brace can work.
Physical therapy can be effective for many at managing patella pain. The physical therapist can assess you and try to adjust and weaknesses or imbalance that may be present.
Many patients find that KT tape helps control pain.
Surgical options are necessary if your patella subluxation symptoms fail to improve with non-surgical treatment. Options include procedures to “re-align” your patella and have it centered in the groove. The exact nature of the procedure which is best for you will depend on why you have patella mal-alignment. This is a complex issue and you should make sure that the doctor you are seeing is well versed in this area.
Please note that my disclaimer applies.
Discuss your patella subluxation case with your provider or Orthopedic Surgeon to see what might work best for you.