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Patellar Instability and Dislocation

 

What is patellar instability and dislocation?

Patellar instability and dislocation refer to a condition in which the kneecap (patella) moves out of its normal position, usually shifting towards the outside of the knee joint. This can result in significant pain, swelling, and instability of the knee. Here's some information about patellar instability and dislocation:

What causes patellar instability and dislocation?

Patellar instability and dislocation can occur due to various factors, including:

  • Trauma: A forceful blow or impact to the knee, such as during a fall or sports-related injury, can cause the patella to dislocate.
  • Anatomical Factors: Certain anatomical factors can contribute to patellar instability, such as a shallow groove in which the patella sits (trochlear dysplasia), a malalignment of the bones in the leg, or laxity in the ligaments that support the patella.
  • Muscle Imbalance: Weakness or imbalance in the muscles around the knee, particularly the quadriceps and hip muscles, can increase the risk of patellar instability.
  • Previous Dislocation: Once the patella has dislocated, the risk of future dislocations may be higher due to potential damage to the supporting structures.

What are symptoms of patellar instability and dislocation?

The primary symptom of patellar instability and dislocation is the sudden onset of severe pain in the front of the knee. Other common symptoms include swelling, difficulty straightening or bending the knee, a feeling of "giving way" or instability, and visible deformity if the patella is dislocated.

How is patellar instability and dislocation diagnosed?

Diagnosis is typically made through a combination of a physical examination, medical history, and imaging studies. The healthcare professional will assess the knee joint for signs of instability, evaluate the range of motion, and perform specific tests to determine the stability of the patella. X-rays or other imaging studies may be ordered to assess the alignment of the bones and detect any damage or fractures.

How is patellar instability and dislocation treated?

Treatment options for patellar instability and dislocation depend on several factors, including the severity of the injury, the patient's age and activity level, and the underlying causes. Conservative treatment may be considered for first-time or less severe dislocations and can involve the following:

Nonsurgical Measures: 

  • Rest, immobilization with a brace or cast, icing, elevation, and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
  • Physical therapy: A structured rehabilitation program to strengthen the muscles around the knee, improve flexibility, and enhance joint stability.
  • Bracing or taping: Use of specialized braces or taping techniques to provide additional support and stability to the patella.

Surgical Intervention:

In cases of recurrent or severe patellar instability, surgical intervention may be recommended. Surgical options can vary depending on the specific factors contributing to the instability and may involve realigning the bones, repairing damaged ligaments, or reconstructing the stabilizing structures around the patella.

Regardless of whether conservative or surgical treatment is pursued, a comprehensive rehabilitation program is essential for restoring strength, stability, and function of the knee. Physical therapy will focus on strengthening the muscles around the knee, improving balance and coordination, and gradually returning to normal activities and sports.

Ask your primary care doctor for a referral to an orthopaedic surgeon or book an appointment online.