Subluxing Patella

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Subluxing Patella

• By Jim Anderson

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What is it?

• A partial dislocation of the patella
• A complete dislocation that spontaneously reduces
  

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Anatomy

• The knee joint is made up of the
• Femur
• Tibia
• patella

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Pathology

• The patella most commonly dislocates laterally
• It can also displace medially, but is rare

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Predisposing Factors

• Weak medial muscles and/or strong lateral
  musculature
• Genu valgum (knock knees) or genu varum (bow
  legged)
• Abnormally shaped patella
• More common in women

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Predisposing Factors cont.

• Patella Alta (high riding patella)
• Probably the most important factor

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Predisposing Factors cont.
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Special Tests

• Patellar apprehension test
• Clarks sign
• Q angle

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Treatment Non-operative

• Quadriceps strengthening
• Isometric
• Isotonic (closed chain)
• Isotonic (open chain)
• Patellar stabilizer brace/taping

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Surgical Treatment

• Arthroscopy
• Smooth articular surface
• Realign patella
• Retinaculum repair
• Open surgery
• Severe malalignment

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Conclusion

• Patella subluxation is a painful injury
• Caused by
• Muscle imbalance
• Abnormal Q angles
• Abnormally shaped patella
• And patella alta

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Conclusion cont.

• Treatment
• Non surgical strengthening
• Arthroscopy
• Open surgery
• Immediate intervention is crucial to prevent
  chronic subluxations!