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Knee instability, also called giving way, refers to knee subluxation, or abnormal opening, during certain activities. Typically, this instability is related to a chronic or acute injury of ligaments called the anterior cruciate ligament and medial collateral ligament. Ligament tears that may cause instability in the knee may be caused by twisting or turning in such a manner as to initiate a tear in the anterior cruciate ligament.
Many people assume when they experience a knee giving way that they are experiencing true knee instability. Most often, this is not the case. When patients complain of knee buckling when they are walking, they are usually describing patellofemoral dysfunction, and not an unstable knee. Although, the symptoms may be similar, the affected structures differ.
Generally, treatment of this condition depends on the extent, or grade of the instability and whether or not the injury is chronic or acute. Typically, most 1 to 2 grade injuries may be successfully treated without surgical intervention; these injuries are usually ligament tears that are not complete. Most grade 3 knee injuries are classified as complete tears. Usually, grade 3 injuries causing instability typically require surgical reconstruction or repair.
Mild to moderate knee injuries that cause instability may be treated with anti-inflammatory medications. Often, knee problems and pain are associated with swelling. Anti-inflammatory medications are not only effective in treating inflammation or swelling, but they are also effective pain relievers. In patients who cannot take these medications, prescription or over-the-counter analgesics can be taken. Although not effective in treating swelling, they may help alleviate pain.
Typically, to diagnosis instability of the knee, the physician will ask the patient to walk around and straighten and flex his knee. The physician may then palpate, or feel the kneecap and surrounding area to determine if bone misalignment is present, or if the muscles are weak. Sometimes, x-rays will be taken to determine if the kneecap is properly aligned.
If it is determined that the knee is dislocated, it may need to be put back into its proper position. Many times, the physician can manually exert gentle pressure to the knee and push it back into proper alignment. This procedure, in addition to strengthening exercises and the use of a stability brace may be effective in alleviating the symptoms of the knee giving way. With proper and effective treatment, the patient often gets relief in one to three months.