Glossary
Patellar maltracking
Quick answer
Patellar maltracking means the kneecap does not glide straight in its groove as the knee bends and straightens, usually drifting or tilting towards the outer side. It can cause aching at the front of the knee and sometimes instability, notes Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.
What it describes
The kneecap normally runs in the centre of the trochlear groove. Maltracking is a broad term for when it sits or moves off-centre. An MRI or CT may report lateral tilt, lateral subluxation or an increased TT-TG distance, a measurement of how far outward the tendon attachment sits.
Causes include weak hip and thigh muscles, a tight outer band of tissue, knock knees, patella alta and trochlear dysplasia.
Why it matters
Off-centre tracking concentrates pressure on part of the kneecap cartilage. People typically feel pain around or behind the kneecap on stairs, squats, kneeling for prayer and after sitting. In more marked cases the kneecap can partly slip out, a feeling of the knee shifting.
Mild tilt on imaging is common and does not always cause symptoms.
How it is treated
Most people do well with physiotherapy focused on hip, gluteal and quadriceps strength, control during squats and landing, and adjusting training load. Taping or a patellar brace can help in the short term. Surgery, such as MPFL reconstruction or tibial tubercle osteotomy, is considered only when there is clear instability or a structural cause that rehabilitation has not addressed.
Frequently asked questions
Can maltracking be fixed with exercise?
In many patients, yes. Strengthening the hip and thigh muscles improves how the kneecap is controlled and often relieves the pain within a few months.
Is maltracking the same as dislocation?
No. Maltracking is the kneecap running off-centre. Dislocation is when it fully leaves the groove. Severe maltracking can increase the risk of dislocation.
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