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Patella Dislocation

OVERVIEW

Patella dislocation is the dislocation of the kneecap that occurs when the kneecap slips sideways out of its original location at the knee joint. The knee joint is where the thighbone, shinbone and kneecap meet. When you bend and straighten your leg, the kneecap normally slides up and down inside the groove. The network of tendons and ligaments helps secure the kneecap within the groove, flexing as the kneecap moves.

When a patella dislocation occurs, the kneecap is forced outside the trochlear groove (a groove in the middle of the lower thighbone or femur). This then makes the kneecap unable to move up and down and lock the knee while pulling the ligaments out of place. Kneecap dislocations often result in ligament tears that require reconstructive surgery.

Signs and symptoms of a patella dislocation:

Signs and symptoms of a patella dislocation depend on the severity of the dislocation and whether the surrounding structures are damaged or not. If the injury is not severe, the kneecap may only be dislocated partially before returning to its original position. This is called a subluxation and may cause the following symptoms:

Stiffness and swelling
The feeling that the kneecap has slipped to one side
Popping or crackling sounds in the knee
Pain, especially at the front of the knee
A feeling of instability
A locking or catching sensation in the knee

When the kneecap has fully dislocated, it may cause symptoms such as:

Inability to walk or stand
Knee locking, making it difficult or impossible to move the leg
Moderate to severe pain
An odd, angular appearance
Severe stiffness and swelling

How is a patella dislocation treated?

If the patella does not reduce by itself, visit your closed emergency unit, and a doctor will reduce the kneecap under sedation. Thereafter conservative treatment includes physical therapy, RICE therapy (rest, ice, compression bandage to ease swelling and support, and elevating the knee to help reduce swelling) and medications. If a dislocation reoccurs, Dr le Roux may recommend the following:

Arthroscopic surgery

This is a minimally invasive procedure that involves inserting a thin tube that has a camera and surgical tools through small incisions on the knee. The orthopaedic surgeon first assesses the extent of the damage and repairs the problem.

Reconstructive surgery

This is a surgical procedure that is indicated for people who have severe injuries or recurrent dislocations. This procedure involves the orthopaedic surgeon repairing the damaged tendons or ligaments and removing and repairing damaged cartilage and bone.

FAQ

1Can I fix a patella dislocation myself?

You may fix it yourself. It is important that you visit your doctor after you have popped it back again in order for your doctor to check for fractures and the damage done to the cartilage and ligaments.

2How is a patella dislocation diagnosed?

The doctor normally diagnoses a dislocated kneecap by asking for a history of your injury and physically examining the knee. Tests such as X-rays may be conducted to check for any related injuries like torn ligaments, cartilage injury or fractures.

3How painful is a dislocated patella?

Patella dislocations are normally very painful, but it varies depending on how far the bone has been forced outside of the joint and how much the surrounding muscles and ligaments, blood vessels and nerves have been injured. When the patella is reduced, the pain improves.

When is the right time to have surgery?

Typically, surgery is indicated when conservative treatment such as pain relievers or cold/heat therapy, has failed.
Dr le Roux will examine you and review your medical history before advising surgery.

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