Patellar Instability and Patellofemoral Pain

Gillette Children’s Specialty Healthcare is a national leader in pediatric orthopedics. Our orthopedic surgeons treat complex conditions—such as patellar instability and patellofemoral pain.

Our Gillette specialists collaborate to provide comprehensive care for every patient. In addition, through Gillette Lifetime Specialty Healthcare, we evaluate and treat patients whose needs continue into adulthood.

Why Choose Gillette?

  • We offer one of the nation’s highest concentrations of orthopedic surgeons who focus on the needs of children—experts who specialize in typical and atypical growth and development.
  • Our experts are skilled in diagnosing and managing patellar instability and patellofemoral pain.
  • We offer facilities and technology designed specifically for people who have complex conditions and disabilities.


Patellar instability occurs when the patella (kneecap) slips out of the trochlear groove, where it sits in the knee joint. Normally, the patella glides smoothly in this groove, allowing it to track in a straight line. Many patients describe patellar instability as the knee “giving way.”

Patellofemoral pain is felt in the front of the knee. Several conditions can cause it.

Patellar Instability and Patellofemoral Pain Symptoms and Effects

Some people only have one episode of patellar instability; others experience it frequently.

The most common symptoms and effects of patellar instability include:

  • Knee pain
  • Swelling
  • A clicking, buckling or locking sensation at the knee
  • Appearance of the patella slipping or sliding out of the knee joint
  • A sensation the knee is giving way

The most common symptoms and effects related to patellofemoral pain include:

  • A dull ache or burning sensation under or around the kneecap when using stairs, squatting, or getting up after prolonged sitting or kneeling
  • A creaking, grinding or grating sensation when moving the knees
  • A sensation of the knee catching when bending

Patellar Instability and Patellofemoral Pain Causes and Risk Factors

Sometimes patellar instability is caused by:

  • A shallow groove
  • Hypermobility
  • An underlying condition
  • Muscle imbalance or weakness
  • Bony malalignment (bones are out of alignment in relation to joints)

Sometimes patellofemoral pain is caused by:

  • Misalignment of the kneecap
  • Dislocation or injury
  • Tight, weak or imbalanced thigh muscles
  • Overuse
  • Excess weight

People who are at the greatest risk for patellar instability and patellofemoral pain are:

  • Teens
  • Overweight or obese
  • Athletes
  • Hypermobile

Patellar Instability and Patellofemoral Pain Tests and Treatment

At Gillette, our specialists typically diagnose patellar instability or patellofemoral pain after reviewing the patient’s medical history and test results and performing a physical examination. We might take X-rays or an MRI to rule out other conditions.

Patellar instability and patellofemoral pain are usually treated effectively without surgery.

Some of the treatments we might recommend include:

  • Activity restrictions/rest
  • Anti-inflammatory medications
  • Ice
  • Physical therapy
  • Bracing

In severe cases—when severe pain isn’t minimized through nonsurgical treatments—we might recommend surgery. Depending of the type of problems the patient is experiencing, we might perform a combination of one or more of the following procedures.

  • Arthroscopy/ Cartilage Procedure: A surgeon uses special tools to smooth the rough surface of any damaged cartilage behind the patella to reduce pain and repair or restore damaged cartilage.
  • Lateral Release/ Ligament Tightening: When misalignment and repeated dislocations of the patella are problems, we’ll perform this surgery to shift the patella back to a more normal position and tighten the inside edge of the knee.
  • Bony Realignment: In cases of severe misalignment, we might perform this surgery to shift the bony attachment of the patellar tendon to a new position on the tibia bone. This changes the way the tendon pulls the patella through the femoral groove.

Our Patellar Instability and Patellofemoral Pain Services

Gillette offers comprehensive services for patients who have patellar instability or patellofemoral pain. Our experts collaborate to develop custom treatment plans for every patient.

Specialties and services most often involved in the care and treatment of patellar instability or patellofemoral pain include:

For more information about Gillette’s specialties and services, search Conditions and Care.

Why Gillette?

Because all children deserve a lifetime of amazing health care.

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