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I was a very active female athlete during my younger years. But I always suffered with a bad Q-angle and patellar tracking problems. If I ever need a knee replacement, will these two problems get in the way of my recovery?

Women often have painful symptoms from patellar tracking problems. The patella (knee cap) is designed to move up and down over the knee joint. The cartilage behind the knee actually fits a groove along the front of the knee. This anatomic design makes it possible for the patella to track up and down for smooth knee motion.

Anything that can pull the patella to one side or the other can change this tracking. The quadriceps muscle comes down the front of the thigh over the top and around the sides of the patella. The quadriceps muscle then attaches just below the knee joint along the front of the lower leg.

The alignment of the quadriceps muscle when measured from hip to knee is called the Q-angle. Many women have an increased Q-angle. This contributes to the patellar tracking problems already mentioned.

Joint replacement implant designs are just beginning to account for differences in knee size, shape, and dimensions between men and women. For the first time, the Q-angle is being considered. Until now, traditional implants were sex-neutral. There was a limited ability to adjust the implant to fit a Q-angle that wasn't an average angle.

Should you ever need a knee joint replacement, your surgeon will carefully take all variables into consideration. Certain adjustments can be made during the operation to get a better fit with improved tracking. Over time, improved implant designs may even eliminate this step.

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