Although patella fractures only account for about one-percent of all skeletal injuries, they are twice as likely to occur in men, than in women. When the ligaments surrounding the patellar (kneecap) are damaged, it can lead to misalignment of the knee. In turn, once the patella slips from its groove, partially (subluxation) or completely (dislocation), the soft structures can no longer keep the knee stable and in position. Patella fractures typically occur as a result of a fall or abrupt blow to the knee.
At OrthoAspen we have an entire team of specialists solely dedicated to addressing knee injuries. Our goal is to help our active patients return to what they love—safely and effectively.
Various factors and conditions may lead to patellar instability, which include:
- Anatomical Defect
Flat feet, fallen arches and congenital abnormalities in the shape of the patella bone can cause misalignment of the knee joint.
- Abnormal “Q” Angle
The “Q” angle is a medical term used to describe the angle between the hips and knees. The higher the “Q” angle, such as in patients with knock knees, the more the quadriceps pull on the patella causing misalignment.
- Patellofemoral Arthritis
Patellar misalignment causes uneven wear and tear and can eventually lead to arthritic changes to the joint.
- Improper Muscle Balance
Quadriceps (the anterior thigh muscles) function to help hold the kneecap in place during movement. Weak thigh muscles can lead to abnormal tracking of the patella, causing it subluxate or dislocate.
In addition to a direct blow to the knee, patella fractures can also occur indirectly when an abrupt contraction of the quadriceps muscle in the knee pull apart the patella.
The most common symptoms of patella instability include:
- Ongoing Pain, especially when standing up from a sitting position
- Unsteadiness or tendency of the knee to “give way” or “buckle”
- Recurrent subluxation
- Recurrent dislocation
- Severe pain, swelling and bruising of the knee immediately following subluxation or dislocation
- Visible deformity and loss of function of the knee often occurs after subluxation or dislocation
- Sensation changes such as numbness or even partial paralysis below the dislocation because of pressure on nerves and blood vessels
The most common symptoms of patella fractures include:
- Difficulty walking
- Problems extending the knee
- Bruising in the knee area
To diagnose the type and extent of patella injury, your OrthoAspen physician will go over past medical history and conduct a physical examination. He/She may also order diagnostic tests such as X-rays, an MRI or CT scan to confirm the diagnosis.
Treatment for patella instability depends on the severity of the condition. Based on the diagnostic reports, your surgeon may recommend conservative treatments such as:
- Physical therapy
- Braces and orthotics
- Pain relieving medications
In the event that non-surgical treatment options don’t produce the desired results, surgery may be recommended.
Considering the type and severity of the injury, your OrthoAspen surgeon will decide on the appropriate treatment procedure.
Potential surgical options for patella injuries include:
- Lateral Retinacular
A release or a cut of the tight ligaments on the lateral side (outside) of the patella enable the patella to slide more easily in the femoral groove.
- Tibial Tubercle Transfer (TTT)
For severe cases of patella instability, a section of bone is removed where the patellar tendon attaches on the tibia. The bony section is then shifted and properly realigned with the patella and reattached to the tibia with two screws.
Your OrthoAspen surgeon may also perform a procedure to realign the quadriceps mechanism by tightening the tendons on the inside or medial side of the knee.
Following surgery, a rehabilitation program may be recommended for better outcomes and quicker recovery.
If you suspect that you may have experienced a patella fracture or are experiencing patella instability, contact one of our OrthoAspen experts by clicking here or call us at 970-544-1289.