Patella Dislocation
What is a Patella Dislocation?
The patella, also known as the “kneecap” sits at the front part of the knee and articulates with the groove at the front of the femur called the “trochlear groove”. This groove accommodates the patella so that it moves in a straight line as the knee bends. A patella dislocation occurs when the patella comes out of the “trochlear groove”, coming to rest on the outside of the joint.
Symptoms of Patella Dislocation
Patients who have dislocated their kneecap may experience:
Treatment options
After the first episode of patella dislocation, the treatment is initially based on the RICE principles: rest, ice, compression and elevation. A knee splint and crutches may be required for a few days to allow for the pain and selling to subside. As soon as symptoms allow, a rehabilitation program under the guidance of a physiotherapist is required.
The aims of physiotherapy are to reduce swelling, restore normal joint motion, restore strength of quadriceps muscle, especially its main inner portion, the vastus medialis oblique (VMO) muscle. The physiotherapist may also recommend stretching exercises of hamstring muscles and the iliotibial band. Occasionally taping of the patella into place may help relieve or reduce the chance of ongoing symptoms.
As the knee function improves and symptoms allow the advanced diagnostics scans mentioned above are performed to evaluate for predisposing factors for patella instability. If the scans are normal physiotherapy and sports education programs may be all that is required for restoration of full function. If the scans are abnormal and particularly if you experience further episodes of instability, surgical treatment may be indicated. The management of patella dislocation has changed in recent times and some surgeons are recommending preventative surgery after the first patella dislocation. This is because repeated dislocations can damage cartilage, leading to an increased risk of arthritis. Depending on the abnormalities found surgical procedures can include one or more of the following: reconstruction of the medial patellofemoral ligament (MPFL), tibial tubercle realignment, realignment of the femoral bone to correct abnormal twisting of the femur or to correct a knocked knee deformity.
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Non-surgical options
Frequently Asked Questions (FAQ)
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Although knee arthritis can affect anyone, there are several factors that can increase the risk of arthritis:
- Genetic predisposition
- Previous knee injury or surgery
- Other joint conditions such as rheumatoid arthritis or gout
- Occupations involving heavy manual work
- Age (over 40)
- Female gender
- Being overweight or obese
- Participation in high impact activities or sports (e.g. running, soccer or rugby)
Knee arthritis typically develops as a result of progressive cartilage wear within the joint. This process may occur naturally with age or be accelerated by factors such as previous injury, altered joint alignment, or increased mechanical load.
In some cases, inflammatory conditions such as rheumatoid arthritis can also contribute to joint degeneration.
