Nonsurgical Treatment For A Dislocated Patella
The vast majority of dislocated kneecaps can be treated nonsurgically, though some extreme cases may require surgical intervention. In most cases, several nonsurgical treatment options will be attempted before considering surgery to realign the kneecap. Common nonsurgical treatments for a dislocated patella may include:
Dislocated Knee The Complete Injury Guide
by Jessica HeggDecember 31, 2017
Millions of Americans suffer from chronic knee injuries. Although rare, a dislocated knee is a serious injury that can have a long-term effects and keep you from the activities you enjoy. Whether you love sports or daily walks, understanding knee dislocation is essential to making a full recovery. Read on to learn about effective treatment options to get you back on your feet.
How To Deal With A Dislocated Knee
This article was medically reviewed by Troy A. Miles, MD. Dr. Miles is an Orthopedic Surgeon specializing in Adult Joint Reconstruction in California. He received his MD from the Albert Einstein College of Medicine in 2010, followed by a residency at the Oregon Health & Science University and fellowship at the University of California, Davis. He is a Diplomat of the American Board of Orthopaedic Surgery and is a member of the American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Association of Orthopaedic Surgery, and the North Pacific Orthopaedic Society.There are 13 references cited in this article, which can be found at the bottom of the page. This article has been viewed 93,051 times.
Studies show that dislocated kneecaps, also called patellar dislocation, are a common injury that usually happen during sports or episodes of heavy physical activity.XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source Dislocation happens when the kneecap, or patella, slides out of place. This can cause discomfort, pain, and swelling. Experts note that in order to properly deal with a dislocated knee, you should get medical attention as soon as possible and give your leg proper time and treatment to fully heal.XResearch source
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Symptoms Of A Knee Dislocation
Intense pain is an immediate symptom of a dislocated patella . Your knee is also likely to be swollen, and the kneecap will look displaced. You may be unable to walk or move the knee after dislocating the knee.
Knee dislocations in some people will pop back in place on their own but will still be painful and swollen.
Key #1 Just Walk Normally
After 2-3 week of bracing its time to get stuck into restoring normal movement. The main priority in this stage, is to walk as normally as possible.
I find that if you can manage this early, your knee will loosen naturally, as its moving like it was designed to. Work on walking with your heel first, and bending the knee as you lift it to take a step.
I have two quick tips to help you with your walking pattern. Try walking backwards this helps to fire up your gluts and hamstrings, encouraging those big muscles to pull their weight.
Next, put some small objects on the ground about 1.5m apart, then as you walk forward, step over them. Step over firstly with your good leg, so your sore leg must bend at the knee to get over the object.
Your body will try to cheat by lifting your hip instead of bending the knee behind you, watch out for this!
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What Are Treatments For Dislocated Knees
Initial treatment and stabilization includes looking after the whole patient, including assessing and treating any other injuries that might be present.
If the knee is dislocated when the patient comes to the emergency department, a medical professional might attempt to relocate the knee dislocation, if possible, to minimize the risk of continued popliteal artery damage.
Knee dislocations are unstable. Most patients will require repair of their fractures and reconstruction of their torn ligaments. This requires an orthopedic surgeon to perform an operation.
Vascular surgeons are also actively involved in the care of knee dislocations because popliteal artery injuries can be catastrophic.
- If there are hard signs of popliteal artery injury, a patient will go immediately to the operating room for artery repair.
- If hard signs are not present, medical professionals may evaluate of the artery with ABI measurements, ultrasound, or CT angiography. If there is evidence of injury, then the patient will go to the operating room for repair.
- Doctors often perform fasciotomy along with the artery repair to prevent the development of compartment syndrome. Physicians split open the thick tissues that divide the muscles in the lower leg to allow swelling to occur.
- If there is no arterial injury, doctors will observe a patient for 2-3 days in the hospital, with repeated testing to make certain that a delayed injury to the artery does not develop.
What Is A Knee Dislocation
For riders, a knee dislocation could mean one of two things.
- A condition that occurs when the thighbone and shinbone lose contact with one another. This is the technical definition for knee dislocation and is less common but more dangerous.
- A condition that occurs when the kneecap slides out of place. This is technically called a patellar dislocation. However, its often mistakenly referred to as a knee dislocation. A patellar dislocation, while still serious, is not often as severe as a knee dislocation. But it is more common.
What Causes A Dislocated Knee
The kneecap connects all the muscles in the thigh to the shinbone . As you bend or straighten your leg, the kneecap is pulled up or down. The thighbone has a v-shaped notch at one end to accommodate the moving kneecap.
In a normal knee, the kneecap fits nicely in the groove. However, if the groove is uneven or too shallow, the ligaments are loose or there is a sharp blow to the kneecap, the kneecap could slide off, resulting in a partial or complete dislocation.
Dislocation Causes And Risk Factors
Dislocations can be caused by events such as a sudden twist of the leg during a basketball game or through a blow to the knee on the soccer field. This type of injury can be commonly seen in dancers as well.
There are certain risk factors that increase the likelihood of dislocating a kneecap. These include having bony abnormalities that make the kneecap less likely to be stable, or having loose ligaments, which are the tissues that connect bone to bone as part of the kneecaps support system. Kneecap dislocation is most common among females between ages 10 and 17.
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Can I Fix A Dislocated Patella Myself
Possibly. The kneecap has been known to pop back into place on its own when the leg is carefully extended. If its too painful to extend the leg, your healthcare provider can give you medication to make it easier. If you do fix it yourself, see your healthcare provider after. Theyll want to check for fractures and for damage done to the cartilage and ligaments.
Three Easy Keys To Recovery Post Patella Dislocation
Ive been lucky and avoided the trauma of experiencing an acute patella dislocation, unfortunately this was not the case for my sister.
She recalled the event where she was running and went to step. She suddenly felt a big pop in her knee as she fell to the ground in pain.
Fortunately for her, the patella popped back in no sooner than it went out, but the pain remained for some time.
Below we will look at how patella dislocations can be managed and in what cases do we need surgery? Before answering these questions lets look at what the management of an acute dislocation is.
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Key #2 Its All About Strength
Especially if you play sport but even if you dont you need to get your muscles strong to avoid this happening again.
First time patella dislocations have about 17% chance of it happening again, but if it does dislocate a second time, the chances that it will keep happening sky-rockets to 49%! The moral of the story is to strengthen while you can.
I like to start with quadriceps, because if these are weak there is potential for your knee to give-way. Particularly the inside muscle called your VMO . You can do this with a simple seated knee extension.
Sit on a chair and straighten the knee all the way to the end put a weight on your foot to make it harder on the quadriceps. Please have a look at our youtube clip for the whole exercise!
Just focusing on quads alone will help, but there are other muscles which are important. As in my previous anterior knee pain blog, you need to get hips and trunk muscles strong! Check out that blog to see some exercises that will help with this.
How Painful Is A Dislocated Patella
Dislocations are often very painful, but there is a range. It depends how far out of joint the bone has been forced, and how much the surrounding muscles and ligaments, blood vessels and nerves have been injured. It will always be painful to move the dislocated joint or bear weight on it. You wont be able to use the limb normally until the joint has been corrected.
If your dislocated patella corrects itself, your pain and mobility may improve. But you should still see your healthcare provider. Theyll check for secondary injuries to the ligaments and guide you through the longer rehabilitation process.
What Is The Difference Between Patella Dislocation And Patella Subluxation
Some people might think they have a patella dislocation when they actually have a patella subluxation. A subluxation is a partial dislocation. It means that the bone is unstable in the joint and may have strayed a little out of its proper place, but it hasnt popped all the way out. When you have a patella subluxation, the kneecap still tracks in the groove and you can still walk, but it may feel uncomfortable or unsteady, and you may hear a popping noise as it moves. A patellar subluxation can result from injury or from general looseness in the joint .
Treatment For A Dislocated Kneecap
If your kneecap has not corrected itself by the time you get to hospital, a doctor will manipulate it back into place. This is known as a reduction.
You may be given medicine to ensure you’re relaxed and free from pain while this is done.
Once the kneecap is back in place, you may have an X-ray to check the bones are in the correct position and there’s no other damage.
You’ll be sent home with painkillers and your leg will normally be immobilised in a removable splint to begin with.
A few weeks of physiotherapy will be recommended to aid your recovery.
Surgery is usually only necessary if there was a fracture or another associated injury, such as a ligament tear.
It may also be done if you have dislocated your kneecap at least once before.
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Causes Of A Dislocated Kneecap
Abnormalities in the support structures surrounding the kneecap or unusual forces to the knee can cause dislocation. The kneecap can dislocate in several different directions most commonly, to the outside of the leg. Specific causes of a dislocated kneecap include planting the foot and rotating a flexed knee, direct trauma to the knee, and hyperextension.
Is A Dislocated Kneecap Serious
A dislocated kneecap isnt usually serious and by following a programme of physiotherapy, 80% of patients will never have another problem with their knee.
You can also help protect your knees by losing weight, strengthening them through exercise, and eating healthily. For more information, read our article on How to protect andstrengthen your hips and knees.
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How Do You Treat A Dislocated Patella
If the kneecap is dislocated and hasnt returned to its proper place on its own, it needs to be put back where it belongs. Your doctor will apply gentle pressure to push it back, a process called reduction. Afterwards, rest, a knee brace and crutches will help the swelling to go down and allow the knee to heal. If the knee is very swollen, draining the knee of fluid can help reduce the discomfort. After a week or two of rest, physical therapy can help strengthen the muscles around the kneecap to help keep it aligned in the trochlear groove, and help the knee get back to a normal range of motion.
If an MRI shows that bone or cartilage has been damaged on the thigh bone or on the underside of the kneecap, arthroscopic surgery may be necessary. Both of these issues can cause locking, buckling or additional pain in the knee. In people who have had more than one dislocation, surgery can recreate the ligament that was torn. Sometimes in addition to ligament surgery, the doctor will recommend realigning the bone in a procedure called a tibial tubercle osteotomy to help keep the kneecap on track. The success rate of surgery for patellar instability is very high. More than 95% of patients have no more dislocations, and more than 85% return to sports they played before their injury at the same or a higher level.
Who Does Patella Dislocation Affect
Anyone can dislocate their patella through injury. However, certain people are more at risk, including:
- Athletes, especially in high-impact sports.
- Dancers, who are prone to quick pivots.
- Teenagers, whose joints and ligaments are looser from constant growth.
- Women, whose wider hips and looser ligaments put more lateral stress on the knee.
- Big and tall men, whose joints are under more pressure.
- People with patellar instability, especially if they have already dislocated their patella.
Doctors dont know what causes congenital patella dislocation, but a higher incidence among family members suggests a genetic link. Certain other congenital conditions are also associated with it, including:
- Larson Syndrome.
- Kneecap visually out of place.
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Nonsurgical Treatment For Kneecap Injury
A kneecap dislocation needs immediate medical attention. Generally at an urgent care or emergency department, doctors will treat the often sharp pain in the knee cap with non-steroidal anti-inflammatory medications and apply gentle pressure to move the kneecap back into place, a process called reduction.
The RICE method of rest, ice, compression and elevation can also be used as a first response to treat the kneecap injury. When treated early, most dislocations do not cause permanent injury. However, sometimes dislocated patella surgery is needed to repair a ligament that tears when the joint is dislocated.
What Should I Do If I Have A Dislocated Knee
A dislocated knee is a rare, but very painful and serious injury. Dislocation occurs when the bones in the knee joint are not in proper alignment. The bones may be disrupted by a traumatic incident like a fall, car accident or sports collision. Knee dislocation is one of the most painful knee injuries you can experience and it can have serious, long-term consequences if the injury isnt treated properly.
Dislocation can tear or damage the ligaments, tendons, bones, muscles, nerves and blood vessels around the knee joint. Keep reading to learn how to identify a dislocated knee and what steps to take next.
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What To Do If You Dislocate Your Kneecap
A dislocated kneecap is not usually serious and will often pop back into place by itself.
But it’s still a good idea to get it checked by a health professional:
- if your kneecap has gone back into place by itself go to your nearest urgent treatment centre or A& E
- if you cannot get to hospital without being in severe pain, you should call an ambulance do not try to put the cap back in place yourself
While you’re on your way to hospital or waiting for an ambulance, sit still with your leg in the most comfortable position.
How Is Patella Dislocation Treated
Reduction: As long as the diagnosis is clear, a knowledgeable healthcare provider will manually relocate the kneecap as soon as possible. This is called a reduction. A patellar dislocation injury that occurs on the playing field can be reduced immediately by a trained healthcare provider if there is one on-site. If you go to the emergency room, they may give you sedatives and pain medication first. Theyll usually correct the joint first and then look at it on an X-ray.
Imaging: Healthcare providers will take imaging tests to see that the kneecap has been properly replaced and plan any additional treatment. X-rays and CT scans can help reveal any preexisting anatomical conditions that may have contributed to the dislocation, as well as any additional injuries. An MRI can give more detailed information on the cartilage and ligaments if its needed. Sometimes an MRI will reveal a previous transient dislocation that wasnt suspected before.
Surgery: If there is significant damage to the bone or to the cartilage and tendons of the knee, your healthcare provider may recommend surgery to repair it. Surgery may also be recommended if you have recurrent patellar dislocations or chronic patellar instability. Repairing and strengthening the cartilage and ligaments is a preventative measure to restabilize the knee. When patellar dislocation is congenital, the joint can only be repaired through surgery.
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Integrity Spine And Orthopedics Treats Spine And Joint Conditions
If youre in need of an orthopedic specialist for treatment of a dislocated knee or other painful knee injuries, call Integrity Spine and Orthopedics. Our board-certified orthopedic surgeons in Jacksonville, FL, perform minimally invasive arthroscopic procedures that can help you make a full recovery from a traumatic injury. Our clinics also offer general orthopedic and pain management services.
Let our team help you get back on your feet and back to doing the activities you love. Call us today at 904-456-0017 or reach out online to request an appointment. We also offer free MRI reviews to qualified patients who want a second opinion contact us for more information.