Knee
Patella instability
by Uperform
Patellar instability is defined as a recurrent subluxation (at least 3 events) that causes the patella to move to the side of the femur.
1) A LITTLE ANATOMY:
The knee joint is made up of 3 bones: the upper femur, the lower tibia and the patella, a small mobile bone in front of the knee. During flexion/extension movements of the knee, the patella slides on the femur. It is a real reflection pulley for the quadriceps (anterior thigh muscle). The patella is stabilized by the trochlea.
2) WHAT IS PATELLAR INSTABILITY? WHAT IS THE DIFFERENCE WITH A DISLOCATED PATELLA? WHAT ARE THE LESION MECHANISMS?
Patellar instability is defined as a recurrent subluxation (at least 3 events) that causes the patella to move to the side of the femur.
In traumatic cases, the patella can even completely come out of its location in the joint to lodge on the outside of the knee. This is called patella luxation.
The mechanisms of injury can be diverse. These are specific to each patient, and it is therefore sometimes complicated to clearly identify the causes:
Ligament instability/laxity
Ligament injury
Patella abnormality
Abnormality of the femoral trochlea (patellofemoral dysplasia)
Violent direct shock
This pathology mainly affects young and active patients, especially women (higher laxity). The first events of dislocation most often occur during the practice of a sport.
Note that the pain associated with this phenomenon is accentuated during movement and generally relieved at rest. General complaints are:
Pain in the knee
Feeling of instability
Joint stiffness
Joint blockage
Crunches
3) IS IT SERIOUS?
Knee instability is a relatively common problem in young athletes. The earlier the diagnosis, the better the prognosis.
The intensity of the pain as well as the level of loss of functionality of the knee are however specific to each situation.
4) IS SURGERY MANDATORY?
Surgery will represent only a tiny proportion of pathologies of this type and should in no case represent a first-line treatment.
It will be reserved for patients whose physio and medical treatments have failed.
5) HOW DOES THE REHABILITATION TAKE PLACE?
The physiotherapy treatment will focus on:
Educating the patient about his pathology and the information to remember in order to avoid recurrences/complications
Obtaining normalized ranges of motion
Gradual rehabilitation of the joint
Overall muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athleticization and rehabilitation in the sporting gesture
6) WILL I RETURN TO MY PRE-INJURY LEVEL?
If this type of pathology needs to be monitored, it will not prevent you from returning to your optimal level of performance.
7) CAN I CONTINUE TRAINING?
In the event of a subluxation episode, it is usually important to stop sporting activity so as not to aggravate the lesion.
Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
8) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!