Patellar Dislocation
by
Michael Jubinville, MPH DefinitionA patellar dislocation occurs when the kneecap slides out of place. The patella is the bone more commonly known the kneecap. It fits securely in a V-shaped groove in front of the knee so that the patella can move up and down when the leg is bent or straightened. Patellar dislocation is very common. Treatment includes nonsurgical manipulation of the patella, immobilization, medications, and physical therapy. In some cases, surgery may be required to repair damage caused by the dislocation.
CausesTrauma or abnormal movement at the knee causes patellar dislocation. Examples include:
Risk FactorsFactors that may increase your chance of patellar dislocation include:
Other factors that can create instability in the patella include:
SymptomsPatellar dislocation may cause:
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done. This will include a thorough exam of your patella to check for tenderness and swelling. If possible, your doctor will have you walk. Your doctor may be able to make the diagnosis based on your symptoms. Images may be taken of your knee. This can be done with: TreatmentIf the patella did not return to the V-shaped groove on its own, the doctor will manipulate it back into place. The knee will be immobilized in a brace for stability and support. A brace may be needed for up to 4 weeks. Activities will be limited until the knee is stable again. MedicationMedications will be given to help reduce swelling and reduce pain. Physical TherapyPhysical therapy may be recommended to:
Improving leg strength may help prevent future dislocations. Electrical StimulationElectrical stimulation treatments may be used to send gentle electrical pulses through the skin into local tissue. These may include:
SurgerySurgery may be needed for recurrent patellar dislocation or dislocations with severe injuries to soft tissue. It may also be needed for those who don’t recover with standard medical therapy. Surgical procedures include:
PreventionTo help reduce your chance of patellar dislocation, keep quadriceps and hamstring muscles strong with strengthening and stretching exercises. RESOURCES:Family Doctor—American Academy of Family Physicians http://familydoctor.org Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org CANADIAN RESOURCES:Canadian Association of General Surgeons http://www.cags-accg.ca Canadian Orthopaedic Foundation http://www.canorth.org References:
Acute patellar dislocation. EBSCO DynaMed Plus website. Available at:
http://www.dynamed...
. Updated July 28, 2015. Accessed November 13, 2017.
Panni AS, Vasso M, et al. Acute patellar dislocation: What to do? Knee Surg Sports Traumatol Arthrosc. 2013;21(2):275-278. Unstable kneecap. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: ...(Click grey area to select URL) Updated August 2007. Accessed November 13, 2017.
8/4/2014 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed...
: Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for conservative management of lateral patellar dislocations and instability in children and young adults aged 8-25 years. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2014 Mar 18.
8/3/2015 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed...: Tuite MJ, Kransdorf MJ, et al. ACR Appropriateness Criteria® acute trauma to the knee. American College of Radiology (ACR). 2014;11. Available at: ...(Click grey area to select URL) Accessed August 3, 2015. Last reviewed November 2018 by
EBSCO Medical Review Board
Warren A. Bodine, DO, CAQSM Last Updated: 8/3/2015 |
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