Patella Tracking Disorder: Causes, Symptoms, and Treatment Options

Introduction

Knee pain is a common issue for many people, particularly active individuals or athletes. One condition that can lead to pain and instability in the knee is patella tracking disorder. This occurs when the kneecap (patella) doesn’t move smoothly within its groove during movement, often shifting too far to one side. Over time, this can cause pain, discomfort, and even damage to the cartilage under the patella. In this article, we’ll explore what patella tracking disorder is, its causes, symptoms, and the treatment options available to help restore proper function and alleviate pain.

What is Patella Tracking Disorder?

Patella tracking disorder refers to the abnormal movement of the patella as it glides up and down in the trochlear groove at the front of the femur. Normally, the kneecap moves smoothly in this groove during activities like walking, running, or bending the knee. However, in people with patella tracking disorder, the kneecap tends to shift laterally (towards the outer side of the knee), which can lead to pain, instability, and mechanical problems in the joint.

Common Causes of Patella Tracking Disorder:

Muscle Imbalance: Weakness in the muscles surrounding the knee, particularly the quadriceps, can lead to improper alignment of the patella.
Tight Ligaments: Tightness in the ligaments or tendons around the knee can pull the patella out of alignment.
Injury: Previous knee injuries, such as dislocations or sprains, can disrupt the proper movement of the kneecap.
Structural Abnormalities: Some individuals are born with anatomical differences, such as a shallow trochlear groove or high-riding patella, which make them more susceptible to tracking issues.

Symptoms of Patella Tracking Disorder

The symptoms of patella tracking disorder can range from mild discomfort to significant pain, particularly during physical activity. It’s important to recognise these symptoms early, as untreated patella tracking disorder can lead to cartilage damage and long-term knee problems.

Key Symptoms Include:

Knee Pain: Pain is typically felt in the front of the knee, especially when bending or straightening the leg. Activities like squatting, climbing stairs, or running can make the pain worse.
Clicking or Popping Sensation: Many people with patella tracking disorder report a clicking or popping sound when they move their knee.
Knee Instability: The knee may feel like it’s going to give way, especially during activities that involve sudden changes in direction or impact.
Swelling: In some cases, the knee may become swollen, particularly after exercise or prolonged periods of activity.
Grinding Sensation: A sensation of grinding (called crepitus) may be felt as the patella moves in an abnormal path over the femur, especially when bending the knee.

Diagnosis of Patella Tracking Disorder

If you’re experiencing knee pain or instability, it’s important to see a healthcare professional for an accurate diagnosis. The diagnosis of patella tracking disorder typically involves a physical examination, during which your doctor will assess your knee movement, strength, and alignment.

Diagnostic Steps Include:

Physical Examination: Your doctor will assess how your patella moves during different activities, such as walking, squatting, or extending the knee. They’ll also check for muscle imbalances or tightness.
Imaging Tests: In some cases, X-rays or MRI scans may be ordered to examine the position of the patella and assess any underlying damage to the cartilage or bones.

Treatment Options for Patella Tracking Disorder

The treatment for patella tracking disorder depends on the severity of the symptoms and the underlying cause of the misalignment. Most cases can be managed with conservative, non-surgical treatments. However, in more severe cases, surgery may be required to correct the alignment.

Non-Surgical Treatments:

Physical Therapy: Strengthening the muscles around the knee, particularly the quadriceps, can help stabilise the patella and improve its tracking. Exercises that focus on improving balance, flexibility, and core strength are often included in physical therapy programmes.
Bracing or Taping: A knee brace or taping technique can help guide the patella into its correct position, reducing pain and preventing further misalignment.
Rest and Activity Modification: Avoiding activities that aggravate the condition, such as running or jumping, can give the knee time to heal. Low-impact exercises, such as swimming or cycling, may be recommended during recovery.
Anti-Inflammatory Medications: Over-the-counter pain relievers, such as ibuprofen, can help reduce inflammation and manage pain.
Orthotics: Custom shoe inserts (orthotics) can help improve alignment by correcting any biomechanical issues, such as overpronation of the feet.

Surgical Treatments:

If conservative treatments don’t provide relief, or if the patella tracking disorder is causing significant damage to the cartilage, surgery may be considered. There are several surgical options available depending on the cause of the misalignment.

Lateral Release Surgery: This procedure involves cutting tight ligaments on the outer side of the knee to allow the patella to move more freely and improve its alignment.
Tibial Tubercle Transfer: In more severe cases, where the patella is positioned too far to one side, this procedure realigns the patella by repositioning the attachment point of the patellar tendon.
Arthroscopic Surgery: Minimally invasive procedures, such as arthroscopy, can be used to remove damaged cartilage or realign the patella.

Preventing Patella Tracking Disorder

While not all cases of patella tracking disorder can be prevented, there are steps you can take to reduce your risk of developing this condition, especially if you’re active or have a history of knee problems.

Strengthen the Quadriceps: Regularly performing exercises to strengthen the quadriceps muscles can help keep the patella aligned during movement. Exercises like straight leg raises, lunges, and wall sits are particularly effective.
Improve Flexibility: Stretching the muscles and ligaments around the knee, particularly the hamstrings and iliotibial (IT) band, can prevent tightness that pulls the patella out of alignment.
Use Proper Footwear: Wearing supportive shoes, especially during physical activity, can help maintain proper leg and knee alignment. Custom orthotics can also be helpful for individuals with flat feet or other biomechanical issues.
Avoid Overloading the Knee: Avoid excessive stress on the knees by cross-training with low-impact exercises like swimming or cycling. Be mindful of repetitive activities that place strain on the knees.

Treating and Managing Patella Tracking Disorder

Patella tracking disorder is a manageable condition with the right approach to treatment and prevention. Whether through physical therapy, braces, or in more severe cases, surgery, many individuals can regain knee stability and reduce pain. If you’re experiencing knee pain or instability, it’s important to seek medical advice to determine the best course of action for your situation. At MSK Doctors, we specialise in diagnosing and treating knee conditions like patella tracking disorder, helping patients regain strength, mobility, and confidence. Contact us today for expert guidance and a personalised treatment plan.

FAQ Section:

What is patella tracking disorder? Patella tracking disorder occurs when the kneecap (patella) moves out of its proper alignment as it glides within the groove at the front of the femur, causing pain and instability in the knee.
What are the main symptoms of patella tracking disorder? Common symptoms include pain in the front of the knee, especially during activities like squatting or climbing stairs, a clicking or popping sensation, and occasional knee instability.
How is patella tracking disorder treated? Treatment options include physical therapy to strengthen the muscles around the knee, bracing or taping to support the kneecap, rest, anti-inflammatory medications, and, in severe cases, surgery to realign the patella.
Can patella tracking disorder go away on its own? In some cases, mild patella tracking disorder can improve with rest and activity modification. However, physical therapy and strengthening exercises are often needed to fully correct the issue.
When should I consider surgery for patella tracking disorder? Surgery may be recommended if conservative treatments fail to improve symptoms, or if the condition is causing significant damage to the cartilage or persistent instability.
How can I prevent patella tracking disorder? Strengthening the quadriceps muscles, improving flexibility in the knee, and wearing proper footwear can help prevent patella tracking disorder. Avoiding repetitive stress on the knee is also key.