Patellar Tracking Disorder - Topic Overview

Topic Overview

What is patellar tracking disorder?

Patellar tracking disorder occurs when the kneecap (patella) shifts out of place as the leg bends or straightens. In most cases, the kneecap shifts too far toward the outside of the leg, although in a few people it shifts toward the inside.

Your knee joint is a complex hinge that joins the lower leg bones (tibia and fibula) with the thighbone (femur). The kneecap is held in place in the front of the knee joint by tendons on the top and bottom and by ligaments on the sides. A layer of cartilage lines the underside of the kneecap, helping it glide along the groove at the end of your thighbone.

The kneecap can shift or rotate off track if the groove is too shallow or if the cartilage is damaged. Ligaments, tendons, or muscles that are too loose or too tight may also lead to a misaligned kneecap.

See a picture of the knee joint.

What causes patellar tracking disorder?

A patellar tracking disorder is usually caused by several problems combined. The shape of the patella; too tight or too loose muscles and tendons in the leg, foot, or hip areas; and overuse may lead to patellar tracking disorder. See a picture of the muscles and tendons related to patellar tracking disorder.

Also, a severe blow to the inside of a healthy knee can knock a kneecap out of alignment or, in extreme cases, dislocate it. Symptoms of a dislocated kneecap include the knee looking misshapen like a bone is out of place, not being able to bend or straighten the knee, knee swelling, and severe pain.

Sometimes patellar tracking problems run in the family. If you have a family member with knee pain, you may want to take preventive measures, such as strengthening your thigh muscles.

What are the symptoms?

If your kneecap is out of alignment, you may have discomfort or pain, especially when you go down stairs, sit for a long time, stand up from sitting, or squat. This kind of pain, also known as patellofemoral pain, may be caused by patellar tracking disorder.

You also may feel a popping, grinding, slipping, or catching of the kneecap when you bend or straighten your leg. Or you may feel that your knee is buckling or giving way, as though the knee suddenly cannot support your body weight.

How is patellar tracking disorder diagnosed?

Some knee problems can be hard to tell apart. Your doctor will ask questions about your past health and carefully examine you to rule out other conditions. Some of the questions might be: When and how did the pain start? Did it start on its own with no direct cause? Or was the pain caused by injury, overuse, or some other problem with the knee? The doctor will also feel and move your knee as part of the physical exam.

You may also have imaging tests such as X-ray, CT scan, and MRI.

How is it treated?

You can try home treatment if your knee is not swollen, dislocated, giving way, or causing you severe pain. Take a break from activities that cause knee pain, like squatting, kneeling, running, and jumping. Put ice on your knee, and use pain medicines you can buy without a prescription.

As your knee pain starts to decrease, begin stretching and strengthening your leg. Strengthening your thigh muscles can help keep the kneecap stable. Your doctor or physical therapist can help you plan an exercise program specifically for your condition. You will probably start with one or two exercises and add others over time. It is important to closely follow the instructions from your doctor or physical therapist.

Knee pain can be a slow and frustrating condition to heal. But most people with pain from patellar tracking disorder gain relief with a few months of treatment and without surgery. As a rule, the longer you have had this problem, the longer it will take to get better.

Most people can gradually return to their previous activity level if they:

• Avoid movements that make symptoms worse.
• Do specific stretches and muscle-conditioning exercises.
• Lose excess weight.
• Tape or brace the knee, in some cases.
• Learn the best way to perform a sport, and wear the right shoes or equipment.

Surgery is usually not necessary for patellar tracking disorder. It is most often used when dislocation happens many times and other treatments have not worked. There are many types of surgery that can realign the kneecap and correct the tracking problem in some people. You and your doctor can decide which surgery is best for you.

How can patellar tracking disorder be prevented?

You may be able to prevent patellar tracking disorder and related knee pain. Avoid activity that overloads and overuses the knee. Stretch your legs and hips well, both before and after activity. Cycling and swimming are especially good activities. Stay at a healthy weight to reduce stress on your knee joints.

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