Patella Instability

Individualized treatment for kneecap instability and recurrent dislocations

Patella instability, also known as patellar instability, occurs when the kneecap (patella) repeatedly slips partially or completely out of its normal groove at the front of the knee. Patients may describe this as a kneecap dislocation, a kneecap that "pops out," or a knee that feels unstable or gives way.

Patella instability can occur following a traumatic injury or develop because of underlying anatomical factors that make the kneecap more likely to dislocate. Recurrent instability may lead to pain, cartilage damage, loose bodies, reduced confidence in the knee, and difficulty returning to work, recreation, or sport.

At Ortho South, every patient receives a comprehensive assessment to determine the underlying cause of the instability and whether non-operative treatment or surgery is most likely to provide a lasting improvement.

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Symptoms of Patella Instability

Common symptoms include:

  • A kneecap that partially or completely slips out of place
  • Recurrent kneecap dislocations
  • A feeling that the knee is unstable or may "give way"
  • Pain at the front of the knee
  • Swelling after an injury
  • Catching or locking if cartilage damage or loose bodies are present
  • Difficulty with stairs, squatting, running, or sports

Some patients experience a single dislocation that never recurs, while others develop repeated episodes of instability.

Assessment

A detailed history and physical examination are essential to determine why the kneecap is unstable.

X-rays help evaluate alignment and bony anatomy, while MRI is often used to assess cartilage injuries, loose bodies, ligament injuries, and other structures that influence treatment decisions.

Many factors contribute to patella instability, including injury to the medial patellofemoral ligament (MPFL), lower limb alignment, the shape of the trochlear groove, patellar height, muscle balance, and other anatomical factors. Identifying the underlying cause is critical because treatment should address the reason the kneecap is unstable rather than simply treating the consequences of the injury.

Non-Surgical Treatment

Many patients—particularly those experiencing a first-time dislocation without significant associated injury—can be successfully managed without surgery. Treatment may include:

  • Physiotherapy
  • Strengthening of the quadriceps and hip muscles
  • Activity modification
  • Bracing when appropriate
  • Gradual return to work, recreation, and sport

The appropriate treatment depends on the severity of the injury, the risk of recurrence, your anatomy, and your individual goals.

When Is Surgery Recommended?

Surgery may be considered for patients who experience:

  • Recurrent patella instability or repeated dislocations
  • Significant cartilage injuries
  • Loose bodies within the knee
  • Persistent instability despite appropriate rehabilitation
  • Anatomical factors associated with a high risk of recurrent dislocation

The decision to proceed with surgery is always individualized. The goal is to restore stability, preserve healthy cartilage whenever possible, and reduce the risk of further damage to the knee.

Surgical Treatment

There is no single operation that is appropriate for every patient with patella instability.

The most appropriate procedure depends on the underlying cause of the instability, your anatomy, your activity level, and whether there has been associated cartilage or bone injury. Depending on the individual patient, surgery may include:

  • Arthroscopic assessment and treatment of cartilage injuries
  • Removal of loose bodies
  • Medial patellofemoral ligament (MPFL) reconstruction
  • Tibial tubercle osteotomy (TTO)
  • Trochleoplasty in carefully selected patients
  • Other realignment or stabilization procedures when indicated

Many patients require a combination of procedures to address both the damage caused by the dislocation and the anatomical factors that contributed to the instability. Rather than performing the same operation for every patient, treatment is tailored to each individual's anatomy, symptoms, and activity goals.

Recovery

Recovery depends on the procedure performed.

Most patients participate in a structured rehabilitation program that includes progressive range of motion, strengthening, balance training, and a gradual return to work, recreation, and sport.

Recovery timelines vary depending on the specific procedure performed and your progress during rehabilitation.

Private Patella Instability Consultation

Ortho South provides comprehensive assessment and treatment of patella instability, recurrent kneecap dislocations, and related patellofemoral conditions.

Following a detailed evaluation, we will discuss the cause of your symptoms, review both non-operative and surgical treatment options, and recommend the treatment most likely to provide meaningful, long-term improvement.

No referral is required to request a consultation.

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