How do you Diagnose Patellar Instability?

Diagnosis involves the following approaches:

A medical history and physical examination will help the physician in diagnosing the patellar instability

The clinical examination for acute cases would show either of the following:

Effusion: An abnormal amount of fluid in the knee joint that oozes out
Contusion: A bruise resulting from leakage of blood from damaged blood vessels into the tissue spaces underneath the skin
Deformity: The knee may become deformed

X-ray: An X-ray maybe advised to confirm the instability. However, the X-ray may be normal if the kneecap returns to its normal position
Magnetic Resonance Imaging (MRI): An MRI may be advised to assess the damage, if any, to the cartilage, which may be caused by traumatic patellar dislocation, patellofemoral ligament tear or knee joint effusion

How do you Treat Patellar Instability?

Patellar instability could be due to various reasons. It is important to diagnose the cause of patellar instability for instituting effective treatment.

At an early stage, the dislocation can be treated without surgery. The typical non-surgical treatments include the following:

Anti-inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, celecoxib, naproxen, and diclofenac, among others may be used to relieve pain, swelling and inflammation. In severe cases, intra-articular injections of corticosteroids may be administered
Restriction of Activities: These include Resting, Ice application, Compression and Elevation (RICE)
Assistive Devices: These are useful for relieving pressure on the knee. These include knee braces, splints and crutches
Physical Therapy: After the specified period of rest, physical therapy is provided to strengthen the muscles of the knee. This helps to prevent the sliding of the kneecap from the groove and increase mobility. Patellar instability exercises include thigh strengthening exercises, which help to heal the injured knee

In some cases, if the knee pain does not subside with non-surgical interventions, surgery may be required. Some surgical interventions are briefly highlighted below:

Arthroscopy / Cartilage Procedure: There could be cases of patellar dislocation where the cartilage can become loose and remains in the knee. This loose body is removed surgically
Lateral Release / Ligament Tightening: In cases where there are recurrent patellar dislocations, despite non-surgical treatments, surgical procedure may be required to place the patella in the appropriate position or reconstruct the patellofemoral ligament
Bone Realignment: In this procedure, the patellar tendon is moved to a new position on the tibia, thereby facilitating the movement of the kneecap through the femoral groove