Background Information On Patella Dislocation
The patella, or kneecap, is a small bone that sits in front of the knee joint. The patella is connected to the thighbone by the quadriceps tendon and helps to stabilize the knee joint. Normally, the patella glides smoothly up and down as the knee bends and straightens. The bony groove that it glides back and forth in is known as the trochlea.
However, sometimes the patella can become dislocated. This means that it slips out of place, usually to the outside of the knee. Patella dislocation occurs when the patella slides out of its normal position. This can happen if there is a sudden force applied to the knee, such as during a fall or car accident.
A dislocated kneecap is a relatively common injury, particularly among young athletes. Symptoms of patella dislocation include knee pain, swelling, and instability. Treatment typically involves wearing a brace or splint to immobilize the knee and allow it to heal. In some cases, surgery may be necessary to repair the damage.
- Difficulty straightening the knee or inability to straighten the leg
- Tenderness around the knee joint
- Inability to bear weight on the injured leg
Kneecap Dislocation Treatment Without Surgery
If your child’s kneecap dislocates, go to the emergency room. Here, the doctor will do an x-ray to see if the kneecap is back in place most of the time it will be. Sometimes, the doctor might have to apply pressure to move the kneecap back into place.
Your doctor may recommend a supportive brace and physical therapy until the knee stabilizes. If the kneecap continues to slide out of place, your doctor may do an MRI to check for any tears in the ligament or loose pieces of bone that might have broken off during the dislocation.
A Note From Cleveland Clinic
A dislocated patella can be scary and painful, but its not as serious as other dislocation injuries. It takes less force to dislocate the patella than other bones, which means there is less likely to be collateral damage to the blood vessels or nerves. It also relocates more easily, sometimes by itself.
If you dislocate your kneecap, the first thing to worry about is putting it back in place. You or a trained professional may be able to fix it on site. If not, your healthcare provider can do it for you with medication to make it less painful. After that, rest and rehabilitation should have you back on your knee in about six weeks.
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How To Stop Knee Cracking And Popping
If youre having any type of pain, swelling, catching, or locking, those are warning signs that you need to see a doctor, Dr. Slabaugh says. But if youre not having any pain , then doing exercises on your own is very appropriate.
To get started, youll need a few pieces of equipment you can easily find online.
Youll need a long foam roller like this one to do the IT band release.
To alleviate the awkward noises and keep potential injuries at bay, try these exercises, courtesy of Eun Jung Decker at React Physical Therapy, three times a week for maximum results.
Knee Slipping Out Of Joint
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Treatment For A Dislocated Patella
Treatment for a dislocated patella starts by getting the kneecap back into its correct position and then there are two options, surgical and non-surgical management. In most cases, rehabilitation is the preferred method, particularly if it is the first instance of dislocation, but if there are associated injuries such as a bone fracture or ligament damage, or if someone has had multiple dislocations, then surgery is advised.
The first line of treatment for a dislocated patella is to relocate the bone back into its normal position, known as a reduction.
The sooner this happens the better as the longer the kneecap remains displaced, the more swelling will develop in and around the joint which makes it harder to reduce.
In some cases the kneecap will spontaneously pop itself back into place as the individual straightens their knee. If this happens, it is still important to seek medical assistance to assess for further injuries and to access a rehabilitation programme.
If the patella remains dislocated, you need to go to the Emergency Room as a doctor will need to relocate it. You may be given medication to control the pain and relax the soft tissues.
The dislocated patella is reduced by placing pressure on the lateral aspect of the kneecap and pushing it inwards at the same time as straightening the knee.
Knee Popping By Activity
Knee Popping and Pain When Bending: If you get knee popping and pain when bending your knee e.g. squatting down, it is most likely due to a problem with the knee cartilage such as a meniscus tear or chondromalacia patella.
Knee Popping When Extending And Bending: If you get knee pain and popping with both knee flexion and extension, it is likely that there is damage to the joint surface such as cartilage damage or knee arthritis. If there is no pain, it is likely to be gas bubbles popping.
Knee Popping With Twisting: Sudden knee pain and popping when you twist is usually doe to a knee ligament injury, most often an ACL injury and/or MCL tear. If the knee swells up or feels unstable after hearing a pop as you twisted, seek medical attention immediately.
Knee Popping When Walking: Almost all the possible causes of knee popping that weâve looked at here can cause knee pain and popping when walking, be it arthritis, runners knee, cartilage tear or ligament injury. There will usually be other symptoms associated here that will lead to a clearer knee pain diagnosis.
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What Is The Fastest Way To Heal A Dislocated Kneecap
Healing will depend on the type of injury and how severe it is. There is no fastest or easiest way to heal a dislocated kneecap. The best thing to do when you dislocate your knee is to rest and avoid putting pressure or weight on the affected leg.
In addition, do not try to reposition your kneecap by yourself. If your kneecap does not pop back on its own, a trained doctor can manually manipulate and reposition your kneecap to its proper place. This procedure is called patellar reduction.
Pain medications will also be given during and after a procedure, especially if you are in considerable pain. If there is excessive fluid in the joint as a result of swelling, this will be removed through joint aspiration wherein a syringe will be used to extract the fluid.
You may need to use a splint or a brace to prevent the kneecap from moving excessively and getting dislocated again. Some individuals may be required to use crutches to minimize putting weight on the affected leg and to allow adequate healing.
Physical therapy will be important to strengthen the muscles and ligaments that hold the kneecap in place and to prevent kneecap dislocation from recurring. It will also help in conditioning your muscles to facilitate your gradual return to your usual activities or sports training.
What Causes A Dislocated Kneecap
A dislocated kneecap can be caused by:
- A blow to the knee, for example if the knee joint collides with another person or object with great force.
- A sudden change of direction while the leg is still planted firmly on the ground, such as during sports or dancing.
- Weak leg muscles which puts pressure on the knee joint.
- A misaligned or elevated kneecap.
Being tall and/or being overweight increases the risk of dislocation and women are also more at risk.
After a dislocated kneecap, the medial patellofemoral ligament may become torn. This is the ligament that secures the kneecap to the inside of the knee. Once it is torn it may not heal with the same level of tension as before. This can lead to recurrent dislocation of the kneecap.
Knee Dislocation And Kneecap Dislocation Are Two Different Conditions
Knee dislocation occurs when the thigh bone moves out of its place relative to the shin bone. This rarely happens and it usually occurs together with ligament and/or tendon rupture.
It is caused by trauma such as falling from a height, sports-related accidents, or an automobile accident. Knee dislocation is a severe injury that involves the entire knee joint and is associated with nerve damage and rupture of the blood vessels.
Kneecap dislocation is a common and less severe injury as it only involves the kneecap or the flat bone in the front of the knee. The kneecap is situated on a groove on top of the knee where the thigh and shin bones meet.
It is kept in place by tendons and ligaments. As you straighten and bend your knee, the kneecap moves along this groove. Kneecap dislocation occurs when the kneecap moves out of its groove as a result of trauma or during sudden twisting or changing direction when the foot is fixed on the ground.
The kneecap can be dislocated on either side of the knee, but it is commonly dislocated towards the outer side.
Should I Sleep With A Knee Immobilizer
A knee immobilizer may be removed for bathing and sleeping, but it must be worn at all times when you are out of bed to stabilize and protect your knee.
If you have a severe case of knee dislocation or kneecap dislocation, you may be required by your doctor to elevate the affected area and wear the immobilizer even while sleeping to avoid putting pressure on the area and unconsciously moving the knee.
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Dislocated Kneecap: When Is Surgery Recommended
Surgery can stabilize the knee and lower the risk of the kneecap becoming dislocated again. It is considered after a second kneecap dislocation or if the knee is very unstable.
The doctor will first push the kneecap back into place. Then there are two treatment options:
- Conservative treatment: The kneecap is stabilized for a few weeks using a brace or bandage. Physical therapy is started at the same time, with the goal of strengthening the muscles that support the kneecap.
- Surgery: Doctors operate on the knee to stabilize the kneecap. During the surgery, cartilage or bone injuries may be treated or misalignments might be corrected as well. Physical therapy is started after surgery too.
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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How Can You Prevent From Dislocating A Knee
Attempt to avoid major accidents. Avoid risky activities such as skiing, motorcycle riding, or jumping from high places people who decide to do these high-risk activities should obtain and follow instructions from experts about how to decrease their risks.
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- Description: Dislocation of the knee is a true limb-threatening emergency. This is also a rare injury. Dislocation of the knee is caused by a particularly powerful blow to the knee. The lower leg becomes completely displaced with relation to the upper leg. This displacement stretches and frequently tears not only the ligaments of the knee but also arteries and nerves. Untreated arterial injuries leave the lower leg without a blood supply. In this case, amputation may be required. Nerve injuries, on the other hand, may leave the lower leg viable but without strength or sensation.
- This injury can be due to a motor vehicle accident where the patientâs knee or leg hits the dashboard.
- Symptoms and signs: Knee dislocations are severely painful and produce an obvious deformity of the knee. Many dislocations are reduced or put back into anatomic alignment spontaneously. As this occurs, many will report feeling a dull clunk.
How Is Kneecap Instability Treated
The first line of treatment is usually nonsurgical. Rest and nonsteroidal anti-inflammatories are encouraged to reduce the swelling and allow for the natural healing of the ligament to occur. Physical therapy is performed to get back range of motion and strength. Most patients can then return to prior levels of activity.
With 3D imaging, we are improving our understanding of this dynamic and complex anatomy and aim to better predict now who will get better without surgery, Dr. Fulkerson says. If surgery is needed, this added information of 3D imaging will hopefully lead to more successful surgery and better long-term outcomes.
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If You Keep Dislocating Your Kneecap
Most people who dislocate their kneecap will not dislocate it again. But in some people it can keep happening.
This often happens if the tissues that support the kneecap are weak or loose, such as in people with hypermobile joints, or because the groove in the bone beneath the kneecap is too shallow or uneven.
Regularly doing the exercises your physiotherapist recommends can help strengthen the tissues that hold the kneecap in place and reduce the risk of dislocating it again.
Surgery may occasionally be needed if the kneecap keeps dislocating. A common procedure is a medial patellofemoral ligament repair.
This is where the connective tissue that helps hold the kneecap in place is repaired and strengthened.
Page last reviewed: 20 May 2019 Next review due: 20 May 2022
When To See A Doctor
If you have any pain along with these symptoms, have a doctor look at your knee as soon as possible. Doing so may prevent a more serious knee injury including anterior cruciate ligament injuries. They affect between 100,000 and 200,000 Americans each year.
Even if the knee popping isnât painful, you may still want to have it checked out. In some cases, it may be an early warning sign of an overuse injury. This may require weight loss, a change of footwear, or knee-strengthening exercises to protect the joint.
The best treatments are targeted directly at the specific problem that is causing the abnormal popping or snapping inside the knee joint. You can ease crepitus and tendon problems with treatments to reduce inflammation in the knee joint, such as rest and anti-inflammatory medications.
Most mechanical problems are best treated with arthroscopic knee surgery. This is a procedure in which a camera and tools are passed through small incisions into the joint to repair any damage.
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Symptoms Of An Unstable Kneecap
You should be aware of a hard knobbly bone that rests in front of your knee. It is called the kneecap, and it gives the muscles in your thigh leverage when you extend your leg. The kneecap also helps protect other parts of your knee. While a network of ligaments and tendons keep your kneecap in place, some people might have looser connective tissue. An unstable kneecap may present symptoms you need to be aware of so that you can take the proper precautions.
Causes Of Patellar Dislocation
If a great enough force goes through the front of the knee, the kneecap shifts out the patella groove.
There may be a:
Patella Subluxation: where the kneecap becomes partially displaced or
Patella Dislocation: where the kneecap is completely displaced
Most commonly, the kneecap shifts laterally due to the lateral ridge of the groove being lower than the medial ridge.
It is extremely uncommon for the kneecap to dislocate medially due to the high medial ridge and strong supporting soft tissues.
A dislocated patella is usually caused by:
- Direct Impact: a sudden force to the front or side of the knee that pushes the kneecap out of place. This is typically the result of a sporting tackle, fall or car accident
- Sudden Twisting: of the knee when the foot is fixed to the ground. This typically happens when someone is running fast and suddenly changes direction. The force through the front of the knee stretches the ligaments and tendons and pulls the kneecap out of place
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