Dr BurkeWhat Is Patellar Tracking Disorder?
Patellar tracking disorder is a condition where the kneecap (patella) moves out of its normal alignment when the knee is bent or straightened. Instead of moving smoothly in the groove at the end of the thigh bone (femur), the kneecap may shift to one side, typically toward the outside of the knee. This abnormal movement can cause pain, discomfort, and instability in the knee, making everyday activities like walking, running, or climbing stairs difficult. At Dr. Burke Orthopedics, we offer expert diagnosis and treatment for patellar tracking disorder to help patients restore normal knee function and relieve pain.
In a healthy knee, the patella moves up and down within a groove in the femur as the knee bends and straightens. Patellar tracking disorder occurs when the patella shifts out of this groove, most commonly moving toward the outer side of the knee. This abnormal tracking can lead to pain, irritation, and damage to the cartilage behind the kneecap, potentially causing long-term issues if left untreated.
Patellar tracking disorder is often associated with conditions like patellar instability, where the kneecap is more likely to dislocate or sublux (partially dislocate), and patellofemoral pain syndrome, where pain occurs due to poor alignment of the kneecap.
Causes of Patellar Tracking Disorder
Several factors can contribute to patellar tracking disorder, including structural abnormalities, muscle imbalances, and injuries. Common causes and risk factors include:
- Muscle Imbalance: Weakness in the inner thigh muscles (quadriceps) and tightness in the outer thigh muscles can pull the kneecap out of alignment, leading to patellar tracking disorder.
- Structural Abnormalities: Some individuals are born with structural abnormalities, such as a shallow groove in the femur, a high-riding patella (patella alta), or an abnormal knee shape, which can affect how the patella moves.
- Previous Knee Injuries: Knee injuries, such as ligament tears or fractures, can disrupt the normal alignment of the kneecap and lead to tracking problems.
- Overuse: Repetitive knee movements, particularly during activities like running, jumping, or squatting, can irritate the patella and contribute to tracking issues over time.
- Tight Ligaments: Tight ligaments or tendons around the knee can cause the patella to be pulled out of its normal position during movement.
- Flat Feet or Foot Misalignment: Foot problems, such as flat feet or abnormal foot alignment, can alter the mechanics of the leg and affect the way the patella moves.
Symptoms of Patellar Tracking Disorder
The symptoms of patellar tracking disorder may vary in severity and can worsen with activity. Common signs and symptoms include:
- Knee Pain: Pain is often felt at the front of the knee, particularly around or behind the kneecap. The pain may worsen with activities such as running, jumping, or squatting.
- Knee Instability: The knee may feel unstable or as though it is "giving way" during movement, especially when walking down stairs or changing direction quickly.
- Popping or Grinding Sensation: A popping, clicking, or grinding sensation (crepitus) may occur when bending or straightening the knee.
- Swelling: Swelling in the knee joint may develop, especially after physical activity.
- Difficulty with Knee Flexion: Some individuals may have difficulty fully bending or straightening the knee due to pain or discomfort.
Diagnosis of Patellar Tracking Disorder
At Dr. Burke Orthopedics, diagnosing patellar tracking disorder involves a comprehensive evaluation of your knee’s movement, alignment, and structure. This includes a physical examination and, if necessary, imaging tests to assess the extent of the misalignment and identify any underlying conditions.
1. Physical Examination: The doctor will examine the knee joint, checking for signs of tenderness, swelling, and abnormal patellar movement during flexion and extension. They may ask you to perform specific movements to observe how the patella tracks and determine whether there is any instability.
2. Imaging Tests:
- X-rays: X-rays provide detailed images of the bones in the knee and can help identify structural abnormalities, such as a shallow femoral groove or misalignment of the kneecap.
- MRI: An MRI may be used to assess the soft tissues around the knee, including the ligaments, tendons, and cartilage. This test is particularly useful for detecting damage to the cartilage behind the kneecap or any soft tissue injuries that may contribute to patellar tracking disorder.
Treatment for Patellar Tracking Disorder
Treatment for patellar tracking disorder at Dr. Burke Orthopedics focuses on relieving pain, correcting the misalignment, and improving knee stability. Both non-surgical and surgical treatment options are available, depending on the severity of the condition.
1. Non-Surgical Treatments:
- Rest and Activity Modification: Avoiding activities that aggravate the knee, such as running, jumping, or squatting, is essential to reduce stress on the patella and allow healing. Modifying your activity levels and avoiding repetitive knee movements can help prevent further irritation.
- Physical Therapy: Physical therapy is a key component of treatment for patellar tracking disorder. A personalized rehabilitation program will focus on strengthening the quadriceps, especially the inner thigh muscles (vastus medialis), to improve patellar alignment. Stretching exercises for the hamstrings and IT band can also help reduce tension on the patella.
- Knee Bracing or Taping: Wearing a knee brace or using taping techniques can help keep the patella in proper alignment during activity. A patellar tracking brace or specialized taping can provide extra support and reduce the risk of misalignment.
- Orthotic Inserts: If foot alignment issues, such as flat feet, are contributing to patellar tracking disorder, custom orthotic inserts may be recommended to improve foot mechanics and reduce stress on the knee joint.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and reduce inflammation in the knee.
2. Surgical Treatments: Surgery may be considered if non-surgical treatments do not provide sufficient relief or if there is significant damage to the cartilage or soft tissues. Surgical options include:
- Lateral Release: In this procedure, the tight ligaments on the outer side of the knee are cut to allow the patella to move more freely and realign properly. This procedure is typically performed arthroscopically using small incisions.
- Medial Patellofemoral Ligament (MPFL) Reconstruction: In cases of recurrent patellar dislocation or severe instability, the MPFL, which helps keep the kneecap in place, may be reconstructed using a tendon graft. This procedure helps improve knee stability and prevent future dislocations.
- Tibial Tubercle Transfer (TTT): This procedure involves repositioning the tibial tubercle, the bony prominence just below the kneecap, to improve the alignment of the patella. TTT is often recommended for patients with chronic patellar tracking disorder who have abnormal knee alignment.
Recovery and Rehabilitation
Recovery from patellar tracking disorder depends on the severity of the condition and the treatment approach. For non-surgical cases, most patients experience significant improvement within several weeks to months with consistent physical therapy.
- Non-Surgical Recovery: Patients undergoing non-surgical treatments can expect gradual improvements in pain, stability, and knee function as they strengthen the muscles around the knee and improve patellar alignment. Most patients can return to their normal activities within 6-12 weeks, depending on the severity of the condition.
- Post-Surgical Recovery: For patients who undergo surgery, recovery times vary depending on the procedure. After surgery, the knee may need to be immobilized for a short period to allow healing, followed by a structured physical therapy program to restore strength, flexibility, and mobility in the knee. Full recovery can take several months, but most patients can return to sports or physical activities with proper rehabilitation.
At Dr. Burke Orthopedics, we provide personalized rehabilitation programs tailored to each patient’s needs, ensuring a full recovery and a return to pain-free movement.
Why Choose Dr. Burke Orthopedics for Patellar Tracking Disorder?
At Dr. Burke Orthopedics, we offer expert care for patients with patellar tracking disorder, providing both conservative and surgical treatment options based on the severity of the condition. Our team of orthopedic specialists is committed to helping patients relieve pain, improve knee function, and prevent future injuries. With advanced diagnostic tools and personalized treatment plans, we ensure that each patient receives the best possible care for their specific condition. Whether you’re dealing with knee pain from sports or everyday activities, Dr. Burke Orthopedics is here to help you on your path to recovery.