Patella Tracking Disorder: Causes, Symptoms, and Treatment

What Is Patella Tracking Disorder

Patella tracking disorder, also known as patellar maltracking, is a condition that affects the movement of the kneecap. The patella, or kneecap, is a small bone that sits in front of the knee joint and helps to protect the joint and provide stability. In a healthy knee, the patella moves smoothly up and down in a groove at the end of the thigh bone, called the trochlea, as the knee bends and straightens.

However, in patella tracking disorder, the patella does not move correctly within the groove, causing it to rub against the bones of the knee joint. This can cause pain, swelling, and inflammation in the knee, as well as a feeling of instability or weakness.

There are several factors that can contribute to patella tracking disorder, including:

• Muscle imbalances or weakness in the quadriceps, hamstrings, or calf muscles
• Trauma or injury to the knee
• Abnormalities in the shape or alignment of the bones of the leg or knee joint
• Overuse or repetitive strain on the knee joint, such as from running or jumping

Patella tracking disorder is most common in young people, particularly women, and athletes who participate in sports that involve a lot of running, jumping, or twisting movements. However, it can also occur in people who are overweight or have a sedentary lifestyle.

If left untreated, patella tracking disorder can lead to more serious knee problems, such as arthritis or cartilage damage. Therefore, it is important to seek medical attention if you are experiencing symptoms of patella tracking disorder, such as knee pain or swelling, or a feeling of instability in the knee.

Causes of Patella Tracking Disorder

Patella tracking disorder is a condition where the patella (kneecap) does not move smoothly in its groove in the thigh bone. The exact cause of this disorder is not always clear, but there are several factors that can contribute to it. This section will explore the most common causes of patella tracking disorder.

Structural Abnormalities

Structural abnormalities in the knee joint can cause patella tracking disorder. For example, the groove in the thigh bone (trochlea) where the patella sits may be too shallow or too flat, causing the patella to move out of place. Similarly, the patella may be abnormally shaped or positioned, making it more likely to dislocate or move off track.

Muscle Imbalances

Muscle weakness or imbalances can also contribute to patella tracking disorder. The quadriceps muscles at the front of the thigh are responsible for extending the knee and stabilizing the patella. If these muscles are weak or imbalanced, the patella may not move smoothly in its groove.

Overuse Injuries

Overuse injuries are a common cause of patella tracking disorder. Activities that involve repetitive knee movements, such as running, jumping, or cycling, can put stress on the patella and its surrounding structures. This can lead to inflammation, pain, and eventually, patella tracking disorder.

Trauma

Trauma to the knee, such as a direct blow or a fall, can also cause patella tracking disorder. In some cases, the trauma may cause damage to the soft tissues that support the patella, making it more likely to move out of place.

Other Factors

Other factors that can contribute to patella tracking disorder include:

• Tight or weak muscles in the hip, leg, or foot
• Arthritis or other degenerative conditions in the knee joint
• Ligament or tendon injuries in the knee
• Poor biomechanics or movement patterns during physical activity

It is important to note that many people may have one or more of these risk factors, but not develop patella tracking disorder. The exact cause of the disorder can vary from person to person, and a combination of factors may be involved.

Symptoms of Patella Tracking Disorder

Patella tracking disorder, also known as patellar maltracking, is a condition in which the patella (kneecap) does not move smoothly in the groove of the femur (thigh bone). This can cause pain, discomfort, and other symptoms. Here are some common symptoms of patella tracking disorder:

• Pain: The most common symptom of patella tracking disorder is pain in the front of the knee. The pain may be dull or sharp, and it may be felt during activities such as running, jumping, squatting, or going up and down stairs. The pain may also be felt when sitting for long periods of time or when standing up after sitting.
• Swelling: Swelling around the knee joint is another common symptom of patella tracking disorder. The swelling may be mild or severe, and it may be accompanied by redness or warmth in the affected area.
• Popping or grinding sensation: Some people with patella tracking disorder may experience a popping or grinding sensation when they bend or straighten their knee. This may be caused by the patella rubbing against the femur or by the patella slipping out of its groove.
• Stiffness: Stiffness in the knee joint is another symptom of patella tracking disorder. The stiffness may be worse in the morning or after sitting for long periods of time.
• Weakness or instability: Some people with patella tracking disorder may experience weakness or instability in the knee joint. This may make it difficult to walk, run, or perform other activities that require the use of the knee joint.

It is important to note that not everyone with patella tracking disorder will experience all of these symptoms. Some people may only experience mild pain or swelling, while others may have more severe symptoms. If you are experiencing any of these symptoms, it is important to see a healthcare professional for an accurate diagnosis and appropriate treatment.

Diagnosis of Patella Tracking Disorder

Diagnosing patella tracking disorder involves a thorough medical history, physical examination, and imaging tests. Doctors will look for symptoms such as pain, swelling, and instability in the knee joint. They will also ask about any previous injuries or surgeries to the knee.

During a physical examination, doctors will check the alignment of the knee joint and the movement of the patella. They may also perform specific tests to assess the strength and flexibility of the muscles and ligaments surrounding the knee joint.

Imaging tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can provide detailed images of the knee joint and help identify any structural abnormalities that may be causing patella maltracking. MRI is particularly useful in assessing the soft tissues around the knee joint, such as the patellar tendon and cartilage.

In some cases, doctors may also use arthroscopy, a minimally invasive surgical procedure, to directly visualize the knee joint and assess the extent of any damage to the patella or surrounding tissues.

It is important to diagnose patella tracking disorder early, as untreated maltracking can lead to cartilage damage and osteoarthritis. With proper diagnosis and treatment, most people with patella tracking disorder can recover and return to their normal activities.

Treatment Options for Patellar Tracking Disorder

There are various treatment options available for patellar tracking disorder, and the appropriate treatment plan will depend on the severity of the condition.

Non-Surgical Treatment

Non-surgical treatment is often the first line of treatment for patellar tracking disorder. This treatment involves physical therapy to strengthen the muscles around the knee joint and improve flexibility. Some of the non-surgical treatment options include:

• Muscle strengthening exercises
• Stretching exercises
• Ice and heat therapy
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Bracing or taping the knee

Surgical Treatment

Surgical treatment is reserved for severe cases of patellar tracking disorder that do not respond to non-surgical treatment. The type of surgery performed will depend on the underlying cause of the condition. Some of the surgical treatment options include:

• Arthroscopic lateral release: This procedure involves cutting the tight lateral retinaculum to release the tension on the patella.
• Medial patellofemoral ligament reconstruction: This procedure involves reconstructing the medial patellofemoral ligament using a graft to stabilize the patella.
• Tibial tubercle osteotomy: This procedure involves cutting and repositioning the tibial tubercle to improve patellar alignment.

Recovery

Recovery from patellar tracking disorder treatment will depend on the severity of the condition and the type of treatment performed. Non-surgical treatment generally has a shorter recovery time than surgical treatment. It is important to follow the treatment plan prescribed by the doctor or physical therapist to ensure the best possible outcome.

Physical Therapy for Patella Tracking Disorder

Physical therapy is an essential component of the treatment plan for patella tracking disorder. The primary goal of physical therapy is to alleviate pain, reduce inflammation, and improve knee function.

One of the most effective physical therapy techniques for patella tracking disorder is strengthening exercises. Strengthening the muscles that support the knee joint can help to improve the alignment of the patella and reduce stress on the joint. The physical therapist may recommend exercises that target the quadriceps, hamstrings, and gluteal muscles. These exercises may include leg presses, squats, lunges, and step-ups.

In addition to strengthening exercises, the physical therapist may also recommend stretching exercises. Tight muscles and tendons can contribute to patella tracking disorder by pulling the patella out of alignment. Stretching exercises can help to improve flexibility and reduce tension in the muscles and tendons surrounding the knee joint. The physical therapist may recommend stretches for the quadriceps, hamstrings, and iliotibial band.

Another physical therapy technique that may be used to treat patella tracking disorder is patellar taping or bracing. Patellar taping involves applying a special tape to the knee to help keep the patella in the correct position. Patellar bracing involves wearing a specially designed brace that helps to support the knee and keep the patella in the correct position.

Finally, proprioceptive training may also be recommended as part of the physical therapy treatment plan. Proprioceptive training involves exercises that help to improve balance and coordination. This can be particularly beneficial for patients with patella tracking disorder, as it can help to improve the alignment of the patella during movement.

Overall, physical therapy is an essential component of the treatment plan for patella tracking disorder. Strengthening exercises, stretching exercises, patellar taping or bracing, and proprioceptive training can all be effective in reducing pain, improving knee function, and preventing further damage to the joint.

Surgical Interventions for Patella Tracking Disorder

Patellar tracking disorder is a condition that can cause significant pain and discomfort in the knee joint. While non-surgical interventions such as physiotherapy and bracing can be effective in managing this condition, surgical interventions may be required in some cases.

The decision to proceed with surgery will depend on the severity of the patellar tracking disorder, as well as the patient’s age, activity level, and overall health. Here are some surgical interventions that may be considered:

Lateral Release

A lateral release is a surgical procedure that involves cutting the lateral retinaculum, a band of tissue on the outer side of the knee that helps to stabilise the patella. This procedure is designed to release tension on the patella, allowing it to track more smoothly in the trochlear groove.

Medial Patellofemoral Ligament (MPFL) Reconstruction

The MPFL is a ligament on the inner side of the knee that helps to keep the patella in place. If this ligament is damaged or stretched, it can contribute to patellar tracking disorder. MPFL reconstruction involves replacing the damaged ligament with a graft, typically taken from the hamstring or quadriceps muscle.

Tibial Tubercle Osteotomy

In some cases, patellar tracking disorder may be caused by an abnormality in the alignment of the knee joint. A tibial tubercle osteotomy is a surgical procedure that involves cutting and repositioning the tibial tubercle, the bony bump on the front of the shinbone where the patellar tendon attaches. This can help to correct the alignment of the knee joint and improve patellar tracking.

Arthroscopic Debridement

Arthroscopic debridement is a minimally invasive surgical procedure that involves using a small camera and surgical instruments to remove damaged tissue from the knee joint. This procedure may be recommended for patients with patellar tracking disorder if there is significant damage to the cartilage or other soft tissue in the knee joint.

Overall, surgical interventions for patellar tracking disorder can be effective in improving symptoms and restoring function to the knee joint. However, it is important to work closely with a qualified orthopaedic surgeon to determine the best course of treatment for your individual needs.

Prevention of Patella Tracking Disorder

Preventing patella tracking disorder involves taking steps to reduce the risk of developing the condition. This includes:

Strengthening Exercises

Strengthening exercises for the muscles around the knee joint can help improve patella tracking and reduce the risk of developing the condition. Exercises that target the quadriceps, hamstrings, and glutes can be particularly effective. Examples of exercises that can help strengthen these muscles include:

• Squats
• Lunges
• Leg presses
• Leg curls
• Step-ups

Stretching

Stretching can help improve flexibility and reduce the risk of developing patella tracking disorder. Stretching exercises that target the muscles around the knee joint can be particularly effective. Examples of stretching exercises that can help reduce the risk of developing patella tracking disorder include:

• Hamstring stretches
• Quadriceps stretches
• IT band stretches
• Calf stretches

Proper Technique

Using proper technique when performing exercises and activities can help reduce the risk of developing patella tracking disorder. This includes maintaining proper form when performing exercises and activities, as well as wearing appropriate footwear.

Managing Weight

Maintaining a healthy weight can help reduce the risk of developing patella tracking disorder. Being overweight or obese can put extra strain on the knee joint, which can increase the risk of developing the condition.

Avoiding Overuse

Avoiding overuse of the knee joint can help reduce the risk of developing patella tracking disorder. This includes avoiding activities that put excessive strain on the knee joint, as well as taking breaks when performing activities that involve repetitive knee movements.

Overall, taking steps to improve knee strength and flexibility, using proper technique, maintaining a healthy weight, and avoiding overuse can help reduce the risk of developing patella tracking disorder.

Living with Patella Tracking Disorder

Living with patella tracking disorder can be challenging, but with the right treatment and management strategies, it is possible to lead a fulfilling life. Here are some tips for managing patella tracking disorder:

Strengthening Exercises

Strengthening exercises can help to improve the alignment of the kneecap and reduce pain. These exercises should focus on the quadriceps muscles, which are the muscles at the front of the thigh. Examples of effective exercises include leg presses, squats, and lunges.

Stretching

Stretching can help to improve flexibility and reduce pain. It is important to stretch both before and after exercise. Stretching should focus on the quadriceps, hamstrings, and calves.

Rest and Ice

Resting the knee and applying ice can help to reduce pain and inflammation. It is important to rest the knee when it is sore and to avoid activities that aggravate the condition.

Knee Braces

Knee braces can help to support the knee and reduce pain. There are many different types of knee braces available, including patella stabilizing braces and compression sleeves.

Pain Medication

Pain medication can help to reduce pain and inflammation. Over-the-counter pain medication, such as ibuprofen and acetaminophen, may be effective. However, it is important to speak to a doctor before taking any medication.

Surgery

In severe cases, surgery may be necessary to realign the kneecap. Surgery may involve tightening or releasing the muscles and tendons around the knee, or realigning the bones in the knee joint.

Living with patella tracking disorder can be challenging, but with the right treatment and management strategies, it is possible to manage the condition effectively. It is important to speak to a doctor or physiotherapist for advice on the best treatment options for your individual needs.

Conclusion

Patellar tracking disorder is a common condition that affects the alignment of the patella (kneecap) with the femur (thigh bone). This misalignment can cause pain, discomfort, and difficulty with movement.

Fortunately, there are several treatment options available for patellar tracking disorder. These include physical therapy, bracing, and surgery in severe cases.

Physical therapy is often the first line of treatment for patellar tracking disorder. This involves exercises to strengthen the muscles surrounding the knee joint, which can help improve patellar alignment.

Bracing can also be effective in treating patellar tracking disorder. A brace can help keep the patella in the correct position during movement, reducing pain and discomfort.

In severe cases, surgery may be necessary to correct patellar tracking disorder. This can involve realigning the patella or repairing any damaged structures in the knee joint.

It is important to note that early diagnosis and treatment of patellar tracking disorder can help prevent long-term complications. If you are experiencing knee pain or discomfort, it is important to seek medical attention to determine if you have patellar tracking disorder or another knee condition.

Overall, with proper treatment, most people with patellar tracking disorder are able to manage their symptoms and return to their normal activities.