Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of recurrent right patellar instability. Reports multiple episodes of the patella shifting out of place, often associated with a sensation of "giving way" or locking. Symptoms are exacerbated by pivoting, twisting, or rapid changes in direction. Denies recent acute trauma, but notes chronic apprehension and persistent anterior knee pain.
Clinical Examination Findings
Right knee examination reveals a positive apprehension sign with lateral patellar translation. Patellar tracking is abnormal with evidence of lateral subluxation during active range of motion. Mild effusion noted. Q-angle is increased. No ligamentous laxity of the ACL, PCL, MCL, or LCL. Tenderness noted along the medial patellofemoral ligament (MPFL) insertion.
Treatment Protocol
Initial management includes physical therapy focusing on VMO strengthening and hip abductor stabilization. Patellar stabilizing brace prescribed for activity. Anti-inflammatory medication as needed. If conservative measures fail, surgical consultation for MPFL reconstruction or lateral release will be considered.