Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of recurrent left patellar instability. Reports multiple episodes of patellar subluxation/dislocation, typically occurring with pivoting or rotational forces. Patient describes a sensation of the knee "giving way" or "popping out," followed by immediate pain, swelling, and apprehension. Previous conservative management noted. No current neurovascular deficits reported.
Clinical Examination Findings
Left knee examination reveals a positive apprehension sign with lateral patellar translation. Patellar tracking is abnormal with evidence of lateral tilt. Mild joint effusion present. Range of motion is full but guarded. Ligamentous stability (ACL/PCL/MCL/LCL) is intact. No focal tenderness over the joint line. Q-angle appears increased.
Treatment Protocol
Initiate physical therapy focusing on VMO strengthening, hip abductor stabilization, and proprioceptive training. Prescribe patellar stabilizing brace for activity. Discuss surgical options, including MPFL reconstruction or tibial tubercle osteotomy, if conservative measures fail to stabilize the patella.