Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentSurgeryFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Surgery
Frequently Asked Questions
The kneecap slides up and down a groove on the end of the thigh bone as the knee bends. This groove is called the trochlea. The kneecap is designed to fit in the center of the trochlear groove and slide evenly within the groove. In some people, the kneecap is pulled towards the outside of the trochlear groove. As this happens, the kneecap does not slide centrally within its groove—we call this patellar subluxation.
DNY59 / Getty Images
Depending on the severity of the patellar subluxation, the improper tracking may not cause the individual any symptoms, or it could lead to dislocation of the patella (where the kneecap fully comes out of the groove). Most commonly, patellar subluxations cause discomfort with activity and pain around the sides of the kneecap called patellofemoral pain syndrome, or PFPS.
Many people with symptoms of kneecap pain are diagnosed with patella subluxation or maltracking of the patella. These issues, with the mechanics of how the knee joint bends, are thought to be a common cause of symptoms that range from knee pain todislocationof the kneecap.
There are dozens of factors implicated in the cause of patellar subluxation. The bottom line is that several factors lead to instability of the kneecap. Possible factors include a wider pelvis, a shallow groove for the kneecap, and abnormalities in a person’s gait.
There has been tremendous interest in recent years of the way our muscles help guide the kneecap as it bends in the knee joint. In particular, the muscles around the hip are thought to be the most important muscles in controlling the mechanics of the joint and how the kneecap moves as the joint bends.
Typically, the pain associated with patellar subluxation is attributed to PFPS. Other causes of kneecap pain include knee arthritis,patellar tendonitis(Jumper’s knee), andplica syndrome. It is important to know that not every cause of kneecap pain is simply the result of patellar subluxation, and other factors may also be important to determine the cause of pain and the treatments that should be recommended.
There are several treatment options to correct a patellarsubluxation, and the most appropriate option depends on the severity of the condition and the cause of the abnormal positioning of the kneecap.
The kneecap position depends not only on the muscles directly around the knee joint but also the muscles that control the position of the entire extremity. For example, when the thigh bone internally rotates, the kneecap will tend to pull to the outside of the trochlea. This is precisely why improving the stability of the core and the hips is so critical to improving the mechanics of the knee joint and relieving patellar subluxation.
Physical therapy:Treatment includes traditional physical therapy, which is used to strengthen the muscles that surround not only the knee but also the entire lower extremity.
Braces and tape:Bracing and taping of the kneecap is also a controversial topic in the rehabilitation of kneecap problems. These often provide symptomatic relief but are certainly not a long-term solution. However, if a patient has symptomatic relief with a brace or tape, it is certainly appropriate to continue with this as a treatment.
Shoe choice:Footwear contributes tothe gait cycle. Motion control running shoes may help control your gait while running and decrease the pressure on the kneecap.
Some of these options for surgical treatment include:
While surgery can be a useful tool to help manage kneecap problems, it is important to clearly understand what the goal of surgery is and how the procedure will help to correct the underlying problem. For a number of years, arthroscopic surgery was performed, as well as a procedure called a lateral release, for vague kneecap problems.
While some patients improved, others didn’t get better with surgery. Simply performing a surgery, without understanding the specific problem being targeted for correction, can lead to unsatisfactory results. Discuss this option if it’s what your healthcare provider recommends and make sure it’s the best option for your situation.
A Word From Verywell
Kneecap function is critical to normal knee mechanics, and when the kneecap is not held in proper position, people can feel significant pain and disability. Correction of patellar subluxation and dislocations can typically be accomplished with nonsurgical treatment, and the mainstay of treatment is physical therapy aimed at improving the mechanics of the lower extremity.
However, there are situations where surgery may be necessary. In these situations, choosing the right surgery is critical to finding success with treatment.
Frequently Asked QuestionsYes, properly taping a kneecap can sometimes help withknee pain. One study found that using the Kinesio or McConnell taping methods can reduce pain when climbing stairs, but might be less effective in more strenuous activities involving the knee.Always follow your healthcare provider’s instructions for managing knee pain.Treating patellar subluxation can require surgery, but it depends on the cause and severity. Non-surgical treatment options include anti-inflammatory medications, several weeks of rest, and physical therapy.Surgical treatment often comes in the form of a soft tissue procedure, such as lateral release. This involves repairing and tightening any stretched tissue causing the subluxation.
Yes, properly taping a kneecap can sometimes help withknee pain. One study found that using the Kinesio or McConnell taping methods can reduce pain when climbing stairs, but might be less effective in more strenuous activities involving the knee.Always follow your healthcare provider’s instructions for managing knee pain.
Treating patellar subluxation can require surgery, but it depends on the cause and severity. Non-surgical treatment options include anti-inflammatory medications, several weeks of rest, and physical therapy.Surgical treatment often comes in the form of a soft tissue procedure, such as lateral release. This involves repairing and tightening any stretched tissue causing the subluxation.
Treating patellar subluxation can require surgery, but it depends on the cause and severity. Non-surgical treatment options include anti-inflammatory medications, several weeks of rest, and physical therapy.
Surgical treatment often comes in the form of a soft tissue procedure, such as lateral release. This involves repairing and tightening any stretched tissue causing the subluxation.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Manske RC, Davies GJ.Examination of the patellofemoral joint.Int J Sports Phys Ther. 2016;11(6):831–853.Koh JL, Stewart C.Patellar instability.Orthop Clin North Am. 2015;46(1):147-57. doi:10.1016/j.ocl.2014.09.011Koh JL, Stewart C.Patellar instability.Clin Sports Med. 2014;33(3):461-76. doi:10.1016/j.csm.2014.03.011Ferber R, Bolgla L, Earl-Boehm JE, Emery C, Hamstra-Wright K.Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial.J Athl Train. 2015;50(4):366–377. doi:10.4085/1062-6050-49.3.70Smith TO, Donell S, Song F, Hing CB.Surgical versus non-surgical interventions for treating patellar dislocation.Cochrane Database Syst Rev. 2015;(2):CD008106. doi:10.1002/14651858.CD008106.pub3Fonseca LPRMD, Kawatake EH, Pochini AC.Lateral patellar retinacular release: changes over the last ten years.Rev Bras Ortop. 2017;52(4):442–449. doi:10.1016/j.rboe.2017.06.003Ibrahim SA, Shohdy EM, Ramadan SA, Almisfer AK, Abdulsattar WS, Khairat S.Medial patellofemoral ligament reconstruction in traumatic patellar dislocation without patellar fixation.J Knee Surg. 2019. doi:10.1055/s-0039-1688841Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J.A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities.Int J Sports Phys Ther. 2013;8(2):105-110. PMID:23593548Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G.Patellar maltracking: an update on the diagnosis and treatment strategies.Insights Imaging. 2019;10(1):65. doi:10.1186/s13244-019-0755-1Additional ReadingSmith, T. Donell, S. Song, F., Hing, C. National Institutes of Health National Library of Medicine. “Surgical versus non‐surgical treatment after kneecap dislocation.“Koh JL, Stewart C. “Patellar instability.” Orthop Clin North Am. 2015 Jan;46(1):147-57.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Manske RC, Davies GJ.Examination of the patellofemoral joint.Int J Sports Phys Ther. 2016;11(6):831–853.Koh JL, Stewart C.Patellar instability.Orthop Clin North Am. 2015;46(1):147-57. doi:10.1016/j.ocl.2014.09.011Koh JL, Stewart C.Patellar instability.Clin Sports Med. 2014;33(3):461-76. doi:10.1016/j.csm.2014.03.011Ferber R, Bolgla L, Earl-Boehm JE, Emery C, Hamstra-Wright K.Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial.J Athl Train. 2015;50(4):366–377. doi:10.4085/1062-6050-49.3.70Smith TO, Donell S, Song F, Hing CB.Surgical versus non-surgical interventions for treating patellar dislocation.Cochrane Database Syst Rev. 2015;(2):CD008106. doi:10.1002/14651858.CD008106.pub3Fonseca LPRMD, Kawatake EH, Pochini AC.Lateral patellar retinacular release: changes over the last ten years.Rev Bras Ortop. 2017;52(4):442–449. doi:10.1016/j.rboe.2017.06.003Ibrahim SA, Shohdy EM, Ramadan SA, Almisfer AK, Abdulsattar WS, Khairat S.Medial patellofemoral ligament reconstruction in traumatic patellar dislocation without patellar fixation.J Knee Surg. 2019. doi:10.1055/s-0039-1688841Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J.A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities.Int J Sports Phys Ther. 2013;8(2):105-110. PMID:23593548Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G.Patellar maltracking: an update on the diagnosis and treatment strategies.Insights Imaging. 2019;10(1):65. doi:10.1186/s13244-019-0755-1Additional ReadingSmith, T. Donell, S. Song, F., Hing, C. National Institutes of Health National Library of Medicine. “Surgical versus non‐surgical treatment after kneecap dislocation.“Koh JL, Stewart C. “Patellar instability.” Orthop Clin North Am. 2015 Jan;46(1):147-57.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Manske RC, Davies GJ.Examination of the patellofemoral joint.Int J Sports Phys Ther. 2016;11(6):831–853.Koh JL, Stewart C.Patellar instability.Orthop Clin North Am. 2015;46(1):147-57. doi:10.1016/j.ocl.2014.09.011Koh JL, Stewart C.Patellar instability.Clin Sports Med. 2014;33(3):461-76. doi:10.1016/j.csm.2014.03.011Ferber R, Bolgla L, Earl-Boehm JE, Emery C, Hamstra-Wright K.Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial.J Athl Train. 2015;50(4):366–377. doi:10.4085/1062-6050-49.3.70Smith TO, Donell S, Song F, Hing CB.Surgical versus non-surgical interventions for treating patellar dislocation.Cochrane Database Syst Rev. 2015;(2):CD008106. doi:10.1002/14651858.CD008106.pub3Fonseca LPRMD, Kawatake EH, Pochini AC.Lateral patellar retinacular release: changes over the last ten years.Rev Bras Ortop. 2017;52(4):442–449. doi:10.1016/j.rboe.2017.06.003Ibrahim SA, Shohdy EM, Ramadan SA, Almisfer AK, Abdulsattar WS, Khairat S.Medial patellofemoral ligament reconstruction in traumatic patellar dislocation without patellar fixation.J Knee Surg. 2019. doi:10.1055/s-0039-1688841Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J.A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities.Int J Sports Phys Ther. 2013;8(2):105-110. PMID:23593548Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G.Patellar maltracking: an update on the diagnosis and treatment strategies.Insights Imaging. 2019;10(1):65. doi:10.1186/s13244-019-0755-1
Manske RC, Davies GJ.Examination of the patellofemoral joint.Int J Sports Phys Ther. 2016;11(6):831–853.
Koh JL, Stewart C.Patellar instability.Orthop Clin North Am. 2015;46(1):147-57. doi:10.1016/j.ocl.2014.09.011
Koh JL, Stewart C.Patellar instability.Clin Sports Med. 2014;33(3):461-76. doi:10.1016/j.csm.2014.03.011
Ferber R, Bolgla L, Earl-Boehm JE, Emery C, Hamstra-Wright K.Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial.J Athl Train. 2015;50(4):366–377. doi:10.4085/1062-6050-49.3.70
Smith TO, Donell S, Song F, Hing CB.Surgical versus non-surgical interventions for treating patellar dislocation.Cochrane Database Syst Rev. 2015;(2):CD008106. doi:10.1002/14651858.CD008106.pub3
Fonseca LPRMD, Kawatake EH, Pochini AC.Lateral patellar retinacular release: changes over the last ten years.Rev Bras Ortop. 2017;52(4):442–449. doi:10.1016/j.rboe.2017.06.003
Ibrahim SA, Shohdy EM, Ramadan SA, Almisfer AK, Abdulsattar WS, Khairat S.Medial patellofemoral ligament reconstruction in traumatic patellar dislocation without patellar fixation.J Knee Surg. 2019. doi:10.1055/s-0039-1688841
Campolo M, Babu J, Dmochowska K, Scariah S, Varughese J.A comparison of two taping techniques (kinesio and mcconnell) and their effect on anterior knee pain during functional activities.Int J Sports Phys Ther. 2013;8(2):105-110. PMID:23593548
Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G.Patellar maltracking: an update on the diagnosis and treatment strategies.Insights Imaging. 2019;10(1):65. doi:10.1186/s13244-019-0755-1
Smith, T. Donell, S. Song, F., Hing, C. National Institutes of Health National Library of Medicine. “Surgical versus non‐surgical treatment after kneecap dislocation.“Koh JL, Stewart C. “Patellar instability.” Orthop Clin North Am. 2015 Jan;46(1):147-57.
Smith, T. Donell, S. Song, F., Hing, C. National Institutes of Health National Library of Medicine. “Surgical versus non‐surgical treatment after kneecap dislocation.”
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
