Question: Hello, my name is Kathryn I am a 19-year-old softball college athlete. About a month ago I noticed severe pain in my knee on the lateral side and worsened from activity. It got so bad that I wasn’t able to bend my leg at all after practice each day and my knee would catch and lock while walking. I have gotten and MRI that reports back with evidence of knee cap instability with tibial tuberosity. Findings are compatible with patellar lateral femoral condyle impingement syndrome. I was also told I had torn off cartilage under my knee cap. I have now taken a month off activity and received a cortisone injection last week for the pain to try and continue activity. Currently, I am still getting the same pain and has now added sharp pains pulsing in my knee throughout the day. My knee cap is very unstable, and I can move it with my leg bent at 90 degrees and feel a slight pop when doing so. Would you recommend that surgery be an option for me? I have tried everything to help this pain but have only been told I need surgery to fix it. If so, what type of surgery would you think they might be an option?
Dr. Kim Foreman: Rest followed by quadricep strengthening exercises and a patellar stabilizing brace are the non-surgical treatments for patellar instability. If these fail then the options are to live with it, reduce activities, or have surgery. There are several surgeries available for correcting patellar instability. The “correct” one is based on which one will best correct the anatomical problem(s) with the knee. This is determined by examining the knee and reviewing the x-rays and MRI.
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