Functional Outcomes of Conservative Treatment of Recurrent Patellar Instability
DOI:
https://doi.org/10.59675/U2211Keywords:
Patellofemoral joint instability, Vastus medialis oblique, Medial patellofemoral ligament, Lysholm knee scoring scale.Abstract
Background: Patellar instability is a common orthopedic condition, particularly among young individuals and females. It is characterized by discomfort during knee flexion or sports activities and accounts for approximately 2-3% of all knee injuries. The incidence rate is 5.8 per 100,000 in the general population and 29 per 100,000 in the 10 to 17-year-old age group. Contributing factors to patellar instability include acute trauma, anatomical abnormalities, and muscle imbalances, which can lead to chronic instability and issues with the patellofemoral joint (PFJ).
Objective: This study aims to evaluate the clinical outcomes of conservative treatment in patients with recurrent patellofemoral joint instability using a combination of exercises targeting the vastus medialis oblique (VMO) muscle.
Methods: A prospective observational study was conducted between December 2023 and July 2024 involving 10 female patients (mean age 30 years) with recurrent patellofemoral joint instability. Patients were treated with VMO strengthening exercises for six months. The functional outcome was assessed using the modified Lysholm knee scoring scale. Pre and post-treatment scores were compared to evaluate the effectiveness of the conservative management approach.
Results: All patients showed improvements in knee function after six months of exercise therapy. The average post-treatment scores indicated good to excellent knee function in the majority of the cases. Conservative treatment reduced pain, improved joint stability, and minimized the risk of recurrent dislocations.
Conclusion: Conservative management, including targeted VMO exercises, effectively improves knee function and reduces the recurrence of patellofemoral joint instability in non-traumatic cases. Surgical intervention remains necessary for severe or recurrent cases unresponsive to physiotherapy
References
Flores GW, de Oliveira DF, Ramos APS, Sanada LS, Migliorini F, Maffulli N, et al. Conservative management following patellar dislocation: a level I systematic review. J Orthop Surg Res. 2023;18(1):393.
Wolfe S, Varacallo M, Thomas JD, Carroll JJ, Kahwaji CI. Patellar instability. 2018.
Hayat Z, El Bitar Y, Case JL. Patella dislocation. 2019.
Cox CF, Sinkler MA, Black AC, Launico MV, Hubbard JB. Anatomy, bony pelvis and lower limb, knee patella. 2023.
Hyland S, Varacallo M. Anatomy, bony pelvis and lower limb, popliteus muscle. 2018.
Wheatley MG, Rainbow MJ, Clouthier AL. Patellofemoral mechanics: a review of pathomechanics and research approaches. Curr Rev Musculoskelet Med. 2020;13:326-37.
Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G. Patellar maltracking: an update on the diagnosis and treatment strategies. Insights Imaging. 2019;10:1-11.
Wheatley MG, Rainbow MJ, Clouthier AL. Patellofemoral mechanics: a review of pathomechanics and research approaches. Curr Rev Musculoskelet Med. 2020;13:326-37.
Samelis PV, Koulouvaris P, Savvidou O, Mavrogenis A, Samelis VP, Papagelopoulos PJ. Patellar dislocation: workup and decision-making. Cureus. 2023;15(10).
Lind M, Faunø P, Sørensen OG, Mygind-Klavsen B. Treatment of patellar instability. Ugeskr Laeger. 2017;179(38):V04170329.
Irish SE, Millward AJ, Wride J, Haas BM, Shum GL. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res. 2010;24(5):1256-62.
Testa EA, Camathias C, Amsler F, Henle P, Friederich NF, Hirschmann MT. Surgical treatment of patellofemoral instability using trochleoplasty or MPFL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017;25(8):2309-20.
Cowan SM, Bennell KL, Crossley KM, Hodges PW, McConnell J. Physical therapy alters recruitment of the vasti in patellofemoral pain syndrome. Med Sci Sports Exerc. 2002;34(12):1879-85.
Pal S, Besier TF, Draper CE, Fredericson M, Gold GE, Beaupre GS, et al. Patellar tilt correlates with vastus lateralis: vastus medialis activation ratio in maltracking patellofemoral pain patients. J Orthop Res. 2012;30(6):927-33.
Chevidikunnan MF, Al Saif A, Gaowgzeh RA, Mamdouh KA. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. J Phys Ther Sci. 2016;28(5):1518-23.
Villafañe JH, Bissolotti L, La Touche R, Pedersini P, Negrini S. Effect of muscle strengthening on perceived pain and static knee angles in young subjects with patellofemoral pain syndrome. J Exerc Rehabil. 2019;15(3):454.
Karimzadehfini A, Zolaktaf V, Vahdatpour B. Restorative effects of exercise rehabilitation and bracing on females with lateral displacement of patella. Adv Biomed Res. 2014;3(1):165.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Academic International Journal of Medical Update

This work is licensed under a Creative Commons Attribution 4.0 International License.


