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tracking disorder means that 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. In a few people, it shifts toward the
Your knee joint is a complex hinge that joins the two bones of the lower leg with the thighbone.
A problem with any of these parts in or around the knee can lead to patellar tracking disorder.
Patellar tracking disorder is usually caused by
several problems combined, such as:
You are more likely to have patellar tracking disorder if you have any of the above problems and you are overweight, run, or play sports that require repeated jumping, knee bending, or squatting.
If you have a patellar tracking problem, you may have:
If your kneecap is completely dislocated, you may have severe pain and swelling. Your knee may look like a bone is out of place. And you may not be able
to bend or straighten the knee. If you have these symptoms, be sure to see your doctor. A dislocated kneecap needs to be put back in place by a doctor right away.
It can be hard to tell the difference between patellar tracking disorder and some other knee problems. To find out what problem you have, your doctor will:
You may have an X-ray so your doctor can check the position and condition of your knee bones. If more information is needed, you may have
Patellar tracking disorder can be a frustrating problem, but be patient. Most people feel better after a few months
of treatment. As a rule, the longer you have had this
problem, the longer it will take to get better.
Treatment of patellar tracking disorder has two goals: to reduce your pain and to strengthen the muscles around your kneecap to help it stay in place. If you don't have severe pain or other signs of a dislocated kneecap, you can try home treatment for a week or two to see if it will reduce your pain.
As your knee pain starts to decrease, do exercises to increase strength and flexibility in your leg and hip. Your doctor or a physical therapist can help
you plan an exercise program that fits your condition. You will probably
start with one or two exercises and add others over time. Make sure to
closely follow the instructions you're given.
Your doctor or physical therapist may also suggest that you:
Most people with patellar tracking disorder can
slowly return to their previous activity level if they:
Surgery usually isn't needed for patellar tracking disorder. You may need surgery if your kneecap dislocates many times or other
treatments haven't worked. There are several types of surgery that can correct a tracking problem. You and your
doctor can decide which surgery is best for you.
Sometimes knee problems run in the family. If a
family member has knee pain, you may want to take steps to help prevent this problem.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about patellar tracking disorder:
Living with patellar tracking disorder:
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
Other Works Consulted
American Academy of Family Physicians (2010). Patellofemoral pain syndrome. Available online: http://familydoctor.org/online/famdocen/home/healthy/physical/injuries/479.html.
American Academy of Podiatric Sports Medicine (2004). Patellofemoral Dysfunction. Available online: http://www.aapsm.org/patellofemoraldys.html.
Earl JE, Vetter CS (2007). Patellofemoral pain. Physical Medicine and Rehabilitation Clinics of North America, 18(2007): 439–458.
Grudziak JS, Musahl V (2007). Patella instability and dislocation in adolescents section of The youth athlete. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, p. 230. New York: McGraw-Hill.
Hudgins T (2008). Patellofemoral syndrome. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp. 371–374. Philadelphia: Saunders Elsevier.
Kaplan L, et al. (2007). Patellar maltracking section of Knee injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 92–95. New York: McGraw-Hill.
Rauh MA, Parker RD (2010). Patellar and quadriceps tendinopathies and ruptures. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 2, pp. 1513–1525. Philadelphia: Saunders Elsevier.
Van Linschoten R, et al. (2009). Supervised exercise therapy versus usual care for patellofemoral pain syndrome: An open label randomised controlled trial. BMJ. Published October 20, 2009 (doi:10.1136/bmj.b4074).
Warden SJ, et al. (2008). Patellar taping and bracing for the treatment of chronic knee pain: A systematic review and meta-analysis. Arthritis and Rheumatism, 59(1): 73–83.
January 23, 2013
Adam Husney, MD - Family Medicine
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