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Healthy knee with properly tracking patella
The space between the patella and the femur is covered with cartilage. This smooth but very tough material covers the joint surface and allows the joint to bend pain free. The VMO and Lateral Retinaculum (LR) are the tissues that have the greatest impact on patella alignment. When these tissues are balanced the patella is likely to be tracking normally in the femoral groove and the contact is evenly distributed over the greatest surface area. This surface contact creates the best knee function with the least amount of pain.

The Problem:
An imbalance with a weakened VMO usually leads to tightening of the Lateral Retinaculum causing the patella to begin tracking laterally. With this, the following problems are likely to occur: Knee pain, swelling, diminished function, or loss of strength. Over time without proper rehabilitation to correct patella alignment, excess wear can erode the cartilage. This will eventually expose the bone resulting in osteoarthritis.

Two primary types of lateral tracking patella

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Patella Glide
Patella glide is a laterl shift of the patella. Surface contact area is reduced and a greater pressure is created on the lateral facet causing pain and decreased function.





Patella Tilt
Patella tilt is a lateral shift and tilt of the patella. There is a significant amount of increased pressure on the lateral facet causing increased pain and decreased function.
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