What is the Patella? Anatomy and Key Functions of the Kneecap

The patella, or kneecap, is the largest sesamoid bone in the body, embedded in the quadriceps tendon in front of the knee joint. Shaped like a flat triangle, it develops between ages 3 and 6 and connects the quadriceps muscle to the patellar ligament, which anchors to the tibia.

Its dense trabecular core and compact outer layer support muscle attachment and blood flow. Stability is provided by the vastus medialis, lateral femoral condyle, and medial patellar retinaculum. Functionally, the patella enhances knee extension and protects the front of the knee joint.

Common Causes of Anterior Knee Pain and the Patella's Involvement

Anterior knee pain occurs when the kneecap doesn’t move properly and rubs against the lower thigh bone. Common causes include:

1. Poor alignment of the kneecap
2. Muscle tightness, weakness, or imbalance
3. Overuse from activities like running, jumping, or sports
4. Shallow femoral groove
5. Flat feet or abnormal leg alignment
6. Weak core or excess weight

It’s more common in overweight individuals, athletes, and teenagers especially girls.

Other causes include arthritis and synovial impingement (plica syndrome).

Patellar Dislocation: Understanding the Injury and Treatment Approaches

Patellar dislocations are fairly common, especially among athletes young female athletes in particular. The kneecap typically dislocates to the outside (laterally), as the medial femoral condyle projects more forward than the lateral one.

To check for a previous dislocation, clinicians may use the apprehension test. This involves applying pressure to the inner (medial) side of the kneecap. If the patient has dislocated it before, they’ll often react with fear or discomfort. Those without prior dislocations usually don’t show concern.

Dislocations can also occur in patients who’ve been on prolonged bed rest. Inactivity causes the vastus medialis (which pulls the kneecap inward) to weaken more than the lateral thigh muscles (vastus lateralis and intermedius). As a result, the stronger lateral pull can shift the kneecap out of place.

Patellar Fractures: Types, Causes, and Management Strategies

A patellar fracture is a break in the kneecap, the small bone at the front of the knee. It often happens due to a direct fall, a hard blow during sports, or impact in a car accident. This injury can make it hard to walk or straighten the knee.

Minor fractures may heal with a cast or splint, but most require surgery if the bone pieces are displaced, to restore knee function and stability.

Types of Patellar Fractures:

Stable fracture: Bone pieces stay aligned; usually heals with a cast or brace.

Displaced fracture: Bone ends are misaligned; surgery often needed.

Comminuted fracture: Bone shatters into several pieces; may need surgical removal of small fragments.

Open fracture: Bone breaks through the skin; urgent surgery required to prevent infection.

Causes:

1. Falling directly on the knee
2. Hard impact (e.g., car accident, sports injury)
3. Sudden strong pull from thigh muscles

Symptoms:

1. Pain, swelling, and bruising at the front of the knee
2. Difficulty straightening the leg or walking

Diagnosis:

1. Physical exam and X-rays
2. Doctor may drain fluid if blood has pooled in the joint
3. Rule out bipartite patella (a normal variant)

Treatment:

Nonsurgical: Cast or splint if bones are aligned

Surgical: Needed for displaced fractures; involves wires, screws, or tension bands

Recovery:

1. Pain managed with ice, elevation, and medications
2. Rehab includes exercises to regain motion and strength
3. Gradual return to weightbearing as healing progresses

Surgical Interventions for Kneecap Issues: When is Surgery Necessary?

Surgery is often required when patellar fractures are displaced, as thigh muscles can pull broken pieces apart, preventing proper healing.

Timing of Surgery: If the skin is intact, surgery may be delayed until surface wounds heal. Open fractures with exposed bone need immediate surgery to prevent infection. The bone and tissue are cleaned, and the patella is repaired in the same procedure.

Surgical Procedures:

Transverse Fracture: Usually treated with screws or pins and a figure-of-eight tension band to hold central breaks together. For smaller fragments or edge fractures, small screws or plates may be used.

Comminuted Fracture: If the patella is shattered into many pieces, fragments may be removed, and the patellar tendon reattached. For central multi-piece fractures, a mix of wires and screws may be used. Partial or full patella removal is a last resort.

Knee Braces for Patellar Support: Choosing the Right Brace for Your Needs

Patellar Stabilizing Brace: Guides kneecap movement. Ideal for tracking issues and mild instability

Patellar Tendon Strap (Cho-Pat Strap): Applies pressure below the kneecap. Helps with jumper’s knee and Osgood-Schlatter

Hinged Knee Brace: Offers side support with hinges. Best for ligament injuries and post-surgery use

Open Patella Knee Brace: Reduces kneecap pressure. Suitable for patellar misalignment and mild pain

Closed Patella Knee Brace: Provides overall compression. Good for general pain and swelling

Dual Strap Brace: Targets support above and below the patella. Ideal for active users with mild instability

Rehabilitation Equipment for Kneecap Recovery: Bands, Weights, and More

Resistance Bands – For targeted quad and hamstring exercises.

Ankle Weights – Add resistance to leg lifts and extensions.

Foam Rollers – Aid in muscle recovery and flexibility.

Exercise Balls – Improve balance and engage stabilizing muscles.

Stationary Bikes – Low-impact cardio for knee mobility and strength.

Leg Press Machines – Build strength in quads, hamstrings, and glutes.

Balance Boards – Enhance coordination and knee joint stability.

Step Platforms – Used for step-ups to improve leg power and control.

Treadmills (with incline) – Boost endurance and lower body strength.

Supportive Wear for Knee Health: Compression Shorts and Sleeves

Knee Sleeves provide compression, reduce swelling, and enhance blood flow. Patellar Straps relieve pressure on the tendon and reduce pain. Compression Pants support overall leg muscles, improving alignment and reducing strain on the knee. Elastic Bandages offer adjustable support and limit excessive knee movement. These garments help stabilize the patella, reduce discomfort, and support recovery.

When it comes to supporting and protecting your knees, Flamingo Knee Cap and Dyna Knee Cap offer excellent solutions for various knee conditions. The Flamingo Black Knee Cap is particularly favoured for its comfort and durability, offering extra support for the knee joint. Whether you're recovering from an injury or seeking preventive support, a Knee Cap can provide the stability your knee needs.

Physiotherapy plays a crucial role in rehabilitation, and incorporating the right knee support, like Flamingo or Dyna, into your routine can enhance the healing process. For those looking to access a wide range of medical equipment, the Medikabazaar platform is an ideal choice. This medical equipment app allows users to easily browse and purchase high-quality products. Whether you're a physiotherapist or an individual looking for knee support, Medikabazaar and its medical app ensure that you have everything you need at your fingertips.

Preventing Patellar Injuries: Tips for Athletes and Active Individuals

1. Strengthening the quadriceps and hamstrings stabilizes the kneecap and maintains alignment, reducing stress on the knee joint and preventing imbalances.
2. Maintaining a healthy weight reduces the strain on the knees, lowering the risk of patellar issues like osteoarthritis and dislocation.
3. Shoes with proper arch support and cushioning help reduce knee pressure, ensuring proper alignment and preventing injuries.
4. A warm-up and stretching routine increases flexibility and blood flow, preventing tight muscles that could strain the knee.
5. Avoid repetitive high-impact activities like running on hard surfaces. Cross-training with low-impact exercises, like swimming or cycling, helps prevent overuse injuries.
6. Knee pads or braces provide additional support during high-impact activities, reducing the risk of trauma.
7. Poor posture or gait misalignment can stress the knee joint and cause patellar pain. A physiotherapist can help correct these issues with specific exercises.