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Kneecap Instability

Kneecap Instability, or patellofemoral pain occurs around the front of the knee and is commonly found in athletes who put heavy stress on their knees. Runners, cyclists, soccer players and downhill skiers just to name a few. The main symptom includes dull, aching pain under or around the kneecap (patella). The pain may be intense when trying to climb stairs, kneel or squat. Patellofemoral pain can be caused by malalignment of the kneecap, excessive overuse or weakness in the thigh muscles.

Symptoms of Patellofemoral pain:

  • Pain in the front of the knee that begins gradually and is activity-related (may be present in one or both knees)
  • Pain during exercise and activities that repeatedly bend the knee (climbing stairs, running, jumping, or squatting)
  • Pain after sitting for a long period of time with your knees bent.
  • Pain related to a change in activity level or intensity, playing surface, or equipment (shoes).
  • Popping or crackling sounds in your knee

Treatment Options for Patellofemoral pain:

Initial treatment follows the RICE formula of rest, ice, compression and elevation. Other alternative conservative treatments may include non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen. Your physician may take X-rays to further evaluate your condition and prescribe other non-surgical options to help you regain full motion of the knee. Some of these options may include an exercise program to increase flexibility and strength in your thigh muscles or use of a knee brace.

Medical treatment for patellofemoral pain syndrome is designed to relieve pain and restore range of motion and strength. In most cases, patellofemoral pain can be treated nonsurgically.

When surgery is needed it is usually performed arthroscopically on an outpatient basis. The surgeon will perform either a lateral release or  tibial tubercle transfer.  Surgery is followed by the use of crutches and an exercise and rehabilitation program to further protect your future knee joint functions.

Arthroscopic Options

During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.


Debridement involves removing damaged articular cartilage from the surface of the patella.

Lateral release

A lateral release is a surgical procedure to release tight capsular structures (lateral retinaculum) on the outer aspect (lateral) of the kneecap (patella)

Tibial Tubercle Transfer

Performed when there have been multiple knee dislocations. Tibial tubercle transfer technique involves realignment of the tibial tubercle (a bump in the front of the shin bone) where the kneecap (patella) traverses in the center of the femoral groove.  This procedure removes the load off the painful portions of the knee cap and reduces the pain.


The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.The information on this site does not replace your doctor's specific instructions.