Patellar Dislocations: Causes, Symptoms, and Treatment
A patellar dislocation occurs when the kneecap (patella) is forced out of its normal position in the groove of the femur. This condition can be both painful and alarming, as the patella plays a vital role in knee stability and movement. While a dislocated patella often happens due to trauma, it can also occur because of underlying issues such as muscle imbalances, ligament weakness, or poor biomechanics. Prompt diagnosis and treatment are essential to ensure proper healing and minimize the risk of future dislocations.
What is a Patellar Dislocation?
A patellar dislocation refers to the displacement of the kneecap from its normal position in the trochlear groove of the femur. This can occur due to a variety of reasons, such as a sudden change in direction, a direct blow to the knee, or excessive force applied to the joint during physical activity.
Patellar dislocations often occur laterally (towards the outer side of the knee), although in rare cases, they may dislocate medially (towards the inner side). When the patella is dislocated, it can cause significant pain, swelling, and difficulty in moving the knee.
Etiology: Causes of Patellar Dislocations
Several factors can contribute to a patellar dislocation:
- Trauma or Injury
The most common cause of a patellar dislocation is direct trauma to the knee, such as a fall, a sports-related collision, or a blow to the knee during activities like football, soccer, or skiing. - Sudden Twisting or Pivoting Movements
A rapid, unexpected change in direction, such as during cutting, pivoting, or jumping in sports, can put enough force on the knee to cause the patella to slip out of place. - Weak or Imbalanced Muscles
Weakness or imbalance in the quadriceps, particularly the vastus medialis (VMO) muscle, can lead to abnormal tracking of the patella. This increases the likelihood of the kneecap slipping out of its groove, especially during activities that require knee flexion or rotation. - Previous Knee Injuries
A history of knee injuries or previous dislocations can make the patella more prone to future dislocations. Ligament damage, especially to the medial patellofemoral ligament (MPFL), can also contribute to instability and increase the risk. - Anatomical Abnormalities
Certain anatomical conditions can predispose individuals to patellar dislocations. These include an abnormally shallow trochlear groove, misalignment of the knee joint, or maltracking of the patella. - Overuse or Repetitive Stress
While less common, overuse and repetitive stress on the knee joint can contribute to the weakening of the stabilizing structures of the knee, leading to a higher risk of patellar dislocations.
Symptoms of Patellar Dislocations
The symptoms of a patellar dislocation are typically quite obvious and may include:
- Severe Knee Pain
Pain is the hallmark symptom of a patellar dislocation, especially at the moment of the injury. The pain is typically localized around the kneecap and may worsen with movement. - Visible Deformity
In the case of a dislocated patella, the kneecap may be visibly displaced to the outside or inside of the knee. This can be alarming and often requires immediate medical attention. - Swelling and Bruising
The knee may swell rapidly, and bruising may appear around the knee joint as blood vessels are damaged. - Inability to Move the Knee
A dislocated patella can cause the knee to feel locked or unable to bend or straighten, making it difficult or impossible to walk or bear weight on the affected leg. - Instability or Giving Way
After the knee is reduced (put back in place), the knee may feel unstable or prone to giving way, especially when engaging in activities that put stress on the joint.
Treatment Options for Patellar Dislocations
Treatment for a patellar dislocation focuses on reducing pain, restoring the patella to its proper position, and preventing future dislocations. The treatment approach depends on the severity of the injury, whether the patella has been relocated, and the presence of any additional damage (e.g., fractures, ligament tears).
Non-Surgical Treatments
- Reduction (Relocation) of the Patella
If the patella is dislocated, the first step is to relocate it back into the groove of the femur. This should only be done by a medical professional to avoid causing further damage to the knee structures. In some cases, the patella may relocate on its own after injury, but medical attention is still required to ensure proper healing. - R.I.C.E. Protocol
The R.I.C.E. protocol is often recommended immediately after the dislocation to reduce swelling and pain:- Rest: Avoid putting weight on the injured leg to allow the knee to heal.
- Ice: Apply ice packs for 20-30 minutes every few hours to reduce swelling.
- Compression: Use an elastic bandage or knee brace to control swelling and provide stability.
- Elevation: Elevate the knee to help reduce swelling.
- Physiotherapy
Physiotherapy is crucial to restore knee function and strength after a patellar dislocation. Treatment may include:- Strengthening Exercises: Focus on strengthening the quadriceps, especially the vastus medialis, to help stabilize the patella and prevent future dislocations.
- Stretching: Stretching tight muscles such as the quadriceps, hamstrings, and calf muscles can improve joint mechanics and reduce strain on the knee.
- Proprioception and Balance Training: Exercises that focus on joint awareness and balance can help improve stability and prevent future injury.
- Athletic Therapy
Athletic therapy is often recommended for athletes or active individuals recovering from a patellar dislocation. An athletic therapist will work to:- Restore Knee Function: Using sport-specific rehabilitation exercises to restore knee mobility and strength.
- Address Muscle Imbalances: Athletic therapy can help correct any muscle imbalances that may contribute to improper patellar tracking and increase the risk of dislocation.
- Massage Therapy
Massage therapy may be used to reduce muscle tension and improve circulation around the knee. Techniques such as deep tissue massage can help alleviate pain, promote healing, and reduce swelling. - Bracing
A knee brace may be recommended to provide additional stability and prevent further dislocations during the healing process. A specialized brace may help keep the patella in place during movement. - Pain Management
Over-the-counter pain medications such as NSAIDs (ibuprofen) can help manage pain and reduce inflammation following a patellar dislocation.
Surgical Treatment
Surgery may be required if there is significant damage to the knee structures, such as fractured bones or torn ligaments, or if the patella continues to dislocate repeatedly. Surgical options include:
- Medial Patellofemoral Ligament (MPFL) Reconstruction: If the MPFL, a ligament that helps stabilize the patella, is torn or stretched, surgery to reconstruct the ligament may be necessary to prevent future dislocations.
- Realignment of the Patella: In cases where the patella is misaligned, surgery may be performed to realign the patella and improve its tracking.
Our clinic works closely with local orthopedic surgeons to ensure a coordinated approach to treatment and rehabilitation if surgery is required.
Why Choose Our Clinic for Patellar Dislocation Rehabilitation?
In Kamloops, our clinic offers comprehensive rehabilitation for patellar dislocations, including physiotherapy, athletic therapy, massage therapy, and kinesiology. We take a holistic approach to recovery, focusing on restoring strength, improving knee mechanics, and preventing future injuries.
Our team works closely with local orthopedic surgeons to streamline care, ensuring that if surgery is necessary, your recovery process is optimized and your rehabilitation is well-coordinated.
Book Your Consultation Today
If you’ve experienced a patellar dislocation, don’t delay in seeking professional care. Our team in Kamloops is here to guide you through every step of your recovery. Book a consultation with us today and start your personalized rehabilitation plan to get you back to an active, pain-free lifestyle!