Patella Instability in Children and Adolescents

What is patella instability in children?

The patella, or kneecap, is a small bone that rests in a groove at the end of the femur (thigh bone). When the knee straightens and bends, the patella moves up or down within the groove. If the groove the patella sits on is shallow or if an accident forces it to slide out of place, patella instability can occur. Patella instability can cause pain and loss of function if not treated properly. Dr. Armando Vidal, orthopedic knee specialist, can diagnose and treat pediatric patients in Vail, Aspen and the surrounding Denver, Colorado communities who have patella instability.

What causes patella instability?

In children and adolescents, there are a several ways in which the kneecap can become unstable or dislocate. In many cases, the patella dislocates with very little force because of an abnormality in the structure of the knee. Other causes may include:

• A shallow or uneven groove at the end of the femur that the patella sits on.
• Children with hyper-flexible joints may have looser ligaments, making them prone to knee dislocations.
• Congenital defects can cause frequent patella instability due to an imbalance of muscle weakness such as Down Syndrome or Cerebral Palsy.
• Recurrent dislocations caused by sports injuries.

What are the symptoms of patella instability in children?

Symptoms of patella instability in children and adolescents can be very similar to symptoms in adults. The severity of symptoms often depends on how far out of place the patella moved and how much tissue damage occurred with the dislocation happened. Some common symptoms in children are:

• Pain in the front of the knee
• The kneecap shifting or sliding out of the groove on the femur
• Knee swelling or pain
• Popping sound or sensation when the patella dislocates
• Feeling of instability or the knee buckling easily

How is patella instability in children diagnosed?

For patients in Colorado, Dr. Vidal will examine the child’s knee while bending and straightening the leg to determine the position of the kneecap. He will palpate the area around the kneecap to determine if the bones are in the correct position and to check for muscle weakness in the thigh. X-rays may help him to determine if the femoral groove is shallow and if it is fitting correctly. If Dr. Vidal suspects soft tissue damage, he may order an MRI scan of the knee to confirm his diagnosis.

What is the treatment for patella instability in children?

The treatment for patella instability in children will vary depending on the child’s age, skeletal grown and if they have open physis (growth plates). The following treatments may be considered:

Non-surgical Treatments:

If the knee is stable and knee dislocation has only occurred once, the treatment may be as simple as a knee brace and physical therapy. For teens with nearly closed growth plates Dr. Vidal may recommend a brace for 3-4 weeks, allowing the knee to heal. Patients may use crutches to keep the weight off the healing knee and, when appropriate, physical therapy should focus on the strengthening of the thigh muscles, gluteals and the vastus medialis obliquus muscles.

Surgical Treatments:

If non-surgical methods have failed to alleviate pain and If the child continues to experience patella instability or recurrent dislocations, surgery may be recommended. The type of surgery will depend on the cause of the patella instability. Some of the options that may be considered are:

• MPFL (medial patellofemoral ligament) reconstruction – This surgery reconstructs the ligaments holding the patella in place on the femur. This procedure is reserved for patients who are skeletally mature and have normal placement of the patella on the femur.

What is the recovery time after patella instability treatment?

Dr. Vidal is a skilled pediatric orthopedic sports medicine specialist and it is important to discuss your child’s patella instability with him to get the proper treatment. Dr. Vidal’s patients often return to their favorite sports activities after a careful physical therapy program which restores their range of motion and strength. The recovery time depends greatly not only on the procedure performed, but on the child’s willingness to complete the required protocol for proper healing. In general, patients in Colorado can expect to return to sports and play in about 4 months.

Pediatric Patella Instability Specialist

Is your child experiencing instability in the knee due to a traumatic injury or congenital conditions? If so, it is recommended to seek out a professional to create an appropriate treatment plan depending on your child’s age and injury. Pediatric patella specialist, Doctor Armando Vidal provides diagnosis as well as specific treatment plans for patients in Vail, Aspen, and the surrounding Denver, Colorado communities who are experiencing patella instability. Contact Dr. Vidal’s team today!