What Is Chronic Knee Instability, and What Are Its Most Common Causes?

If you frequently experience weakness or buckling of your knee, a feeling of looseness, or the sensation that your kneecap is shifting, you may have what’s known as chronic knee instability. This condition can make everyday activities more challenging and increase your risk of falls or further injury. While occasional knee instability can happen after an injury, repeated episodes may require medical evaluation and treatment. 

In this article, we’ll explain what chronic knee instability is, explore its most common causes and address treatment options that can help you recover and get back to enjoying your normal daily activities. 

If you’re experiencing knee instability, it’s important to have it evaluated and treated to prevent long-term complications. At The Bone and Joint Surgery Clinic, we’ve been providing expert care and treatment of knee conditions to Raleigh and Triangle area residents for decades. We invite you to reach out to us for an appointment so we can create a personalized treatment plan to help you recover and find relief. 

What is Chronic Knee Instability?

Chronic knee instability is a condition in which your knee frequently feels loose, prone to giving way or unable to support your weight. Rather than moving smoothly during activity, it may buckle or shift.

Knee instability itself is not a diagnosis. It’s typically a symptom of an underlying issue with the structures that stabilize the knee, such as:

• Ligaments
• Cartilage and menisci
• The joint capsule surrounding the knee
• Supporting muscles

Chronic knee instability can develop when one of these structures is damaged or not functioning properly.

Common symptoms of knee instability may include:

• Knee pain or soreness
• Swelling after activity
• Feeling as if the knee may collapse or give way
• The sensation of your knee shifting, sliding or slipping
• A popping or snapping sensation during movement 
• Difficulty climbing stairs, walking on uneven surfaces or engaging in sports activities

What Are the Most Common Causes of Knee Instability?

Several factors can contribute to knee instability. 

Common causes may include:

• Injuries to stabilizing ligaments such as the:
  • ACL (anterior cruciate ligament)
  • PCL (posterior cruciate ligament)
  • MCL (medial collateral ligament) 
  • LCL (lateral collateral ligament)
• Muscle weakness in the quadriceps, hamstrings, hip muscles or core muscles, which may reduce joint control during movement
• Arthritis or cartilage damage which can affect joint alignment and reduce knee stability over time
• Structural differences you’re born with, such as loose ligaments or very flexible joints (joint hypermobility), which may cause problems after an initial injury
• Patellar (kneecap) instability from previous kneecap dislocations, which can stretch or damage the soft tissues that keep the kneecap centered
• Repeated stress from sports like basketball, soccer, football, volleyball and others that involve jumping, cutting, pivoting or quick changes in direction

Can Physical Therapy Help with Chronic Knee Instability?

Physical therapy can be one of the most effective treatments for many people with chronic knee instability because it addresses the underlying causes of the condition rather than treating symptoms alone.

Physical therapy focuses on enhancing strength, stability and movements that support the knee. For example, we may develop a program for you that strengthens the network of muscles that help control knee alignment, such as the:

• Quadriceps
• Hamstrings
• Hip muscles
• Core muscles

Treatment may also include exercises to help improve:

• Balance 
• Coordination
• Flexibility 
• Functional movement 

Many people can regain strength and function through physical therapy, avoiding the need for surgery. 

Can Knee Braces Help with Instability?

A knee brace can provide additional support for some people with chronic knee instability, depending on the underlying cause. 

We can offer guidance to help you choose the best brace type depending on the cause of your knee instability.

While a knee brace may offer helpful short-term symptom management and support, it does not repair torn ligaments or fix structural issues in your knee. Overly relying on braces may also contribute to muscle atrophy. 

The most beneficial approach is to use knee braces together with physical therapy and other treatments we may recommend, depending on your condition. 

Bracing is not recommended if you have severe ligament damage that requires surgery or your instability is related to nerve or hip issues.

When is Surgery Necessary for Knee Instability?

Though many people recover from knee instability with conservative treatments like physical therapy, activity modification, bracing and anti-inflammatory medications, in some cases, surgery may be necessary.

For example, surgery may be recommended if you experience: 

• Complete ligament tears
• Significant cartilage damage
• Repeated kneecap dislocations
• Structural abnormalities that contribute to ongoing instability
• Persistent knee instability despite conservative treatments 

The type of procedure you have will depend on the underlying cause of the instability and the structures involved. 

Common surgical approaches may involve:

• Repairing or reconstructing damaged ligaments
• Stabilizing the kneecap
• Adjusting bone alignment if the kneecap tracks poorly
• Removing loose or damaged cartilage or bone fragments 

Depending on the procedure, recovery may take 6 to 12 months of rehabilitation to help restore strength, mobility and full function.

Experiencing Knee Instability? Let Our Experts at Raleigh Bone and Joint Surgery Clinic Help You Find Relief 

We understand how frustrating it can be when knee instability makes your everyday activities challenging and compromises your quality of life. The good news is, chronic knee instability is often treatable once the underlying cause is identified. 

Our team of orthopedic specialists at Raleigh Bone and Joint Surgery Clinic can develop a personalized treatment plan for you based on a thorough evaluation of your knee anatomy, your symptoms and what’s causing your condition. 

We’ve been providing expert care and treatment of knee conditions to Raleigh and Triangle area residents for decades. We invite you to contact us for an appointment, so we can help you regain stability and return to the activities you love.