Orthoses for patella tracking disorder

Orthoses for patella tracking disorder

Steve Gaw

8/27/2008

I am looking for an orthotic solution to control extreme patella tracking disorders.  In the past 2 weeks, we’ve seen a patient with extreme lateral patella tracking and another with patella alta causing unstable gait and/or knee pain.  Both patients were referred to us for KOs after physical therapists tried unsuccessfully to control the patella tracking through taping.  In both cases, we’ve first attempted to use an OTS knee sleeve with a patella stabilization pad.  However, the patients were able to overpower the OTS orthoses and their patellas continued to track laterally or proximally as the quadriceps contracted.    We then discussed custom KO options with both patients, as we were able to control their patellas manually as they contracted their quadriceps.  However, the force required to gain purchase on and hold the patella was extreme and would likely be intolerable for the patients for long-term use.  We are seeking orthotic
 solutions, both custom and OTS, to hold the patella and are also tolerable for long-term wear.  Any suggestions will be greatly appreciated.  Thanks in advance.

Stephen Gaw, Orthotic Resident
Atlanta Prosthetics and Orthotics