“Trick Knee” Specialist

Do you have knee pain or the feeling that your kneecap is moving out of its normal positions? Do you have trouble walking after sitting for a long period of time? If so, you may have a knee condition called “Trick Knee” or luxating patella. Knee injury and knee instability specialist, Doctor Riley J. Williams provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, Brooklyn, New York City and surrounding areas who are experiencing symptoms of a trick knee or luxating patella. Contact Dr. Williams’ team today!

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What is a “Trick Knee?”

A trick knee, as it is often called, is called a luxating patella in medical terms. The patella is the kneecap, which is one of three bones that make up the knee joint. The patella or kneecap sits in the front of the knee. The patella glides up and down during leg movement in a groove on the front of the femur that is called the trochlear groove.  The patella is held in place by tendons and ligaments. Luxation or subluxation describes the situation when the affected body is moving abnormally out of place. A complete luxation or subluxation is called a dislocation.  Therefore, a luxating patella is a kneecap that moves too far out of the trochlea. The subluxation or dislocation forces the patella to the outer side of the knee usually during bending or pivoting activities. A “trick knee”, or knee that spontaneously gives way or collapses, can occur while playing sports or during normal activities of daily living. Unstable or subluxating kneecaps are one of the main causes of a trick knee. Other knee instability scenarios, such as anterior cruciate ligament (ACL) deficiency can also cause knee giving way and instability; these knees can also be described as a “trick knees”. Dr. Riley J. Williams, orthopedic knee specialist, serving Manhattan, Brooklyn, New York City, NY and surrounding areas, has extensive experience in treating a luxating patella, ACL tears, and other issues related to knee buckling, or trick knee issues.

What are the symptoms of a luxating patella?

Individuals in the New York area who have concerns with knee buckling or their trick knee often report the following symptoms:

  • Feeling of the kneecap moving out of normal position
  • Knee collapse or giving way
  • Pain
  • Swelling
  • Catching of the knee
  • Pain after sitting for long periods of time
  • Popping of the knee
  • Stiffness
  • Instability

How is a trick knee or luxating patella diagnosed?

Dr. Williams will perform a physical examination of the injured knee by bending and straightening the leg while, feeling for the placement of the kneecap. He will check for both patellar instability and anterior knee instability associated with ACL tears. He will also order an x-ray to provide images of how the patella fits into the trochlear groove. An MRI may be required to assess the stabilizing ligaments of the patella (medial patellofemoral ligament) and the ACL. An MRI can show damage to soft tissue such as tendons and ligaments which may also play a role in the instability of a trick knee. Cartilage injuries can occur with these ailments; MRI scans will help in diagnosing such injuries.

What are the treatment options for a luxating or subluxating patella?

Non-surgical treatment:

Non-surgical treatment is typically recommended for the first time an individual experiences this type of injury. However, if this injury does occur, there is a 33 percent chance of it reoccurring. Treatment options include:

  • RICE (rest, ice, compression, elevation). Icing the injury 20 minutes at a time for the first 24- 48 hours of the initial injury are crucial to mitigate swelling and bruising
  • Crutches or a cane to take pressure off the knee while walking
  • NSAIDs (non-steroidal anti-inflammatories) such as ibuprofen
  • Knee brace
  • Physical therapy

Surgical treatment:

Surgery may be recommended if you have experienced significant disability associated with a “trick knee”. For unstable knees associated with subluxating patellas, the following surgeries may be recommended: (I will link to appropriate articles)

  • Medial patellofemoral ligament (MPFL) reconstruction or repair
  • Tibial tuberosity transfer or tibial tubercle osteotomy
  • Knee arthroscopy with lateral retinacular release.

For unstable knees associated with ACL tears or insufficiency, ACL reconstruction is almost always recommended to relieve symptoms and restore knee stability.

How long is the recovery from trick knee surgery?

Recovery may take as little as 2-3 months to return fully to normal daily activities. A return to sports may take 6-9 months after surgery. Physical therapy will help ensure proper healing and functional recovery. With surgery, patients are much less likely to have a recurring trick knee. Care must be taken in accurately diagnosing the true cause of trick knee before moving ahead with any surgical procedure. As such, patients should seek the expertise of Dr. Riley J. Williams who has extensive experience in treating trick knees, luxating patella, patella instability and ACL tears.

For more information on trick knee, or a luxating patella and the treatment options available, please contact the office of Riley Williams, MD, orthopedic knee specialist serving Manhattan, Brooklyn, New York City, NY and surrounding areas.

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212.606.1855
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Locations

HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895