Dislocated Patella
A dislocated patella can occur with many
different types of sports activities, including contact sports like
football and rugby, or non-contact sports like basketball and soccer.
A
patellar dislocation is a significant injury that must be treated
correctly for a full recovery.
How it
Happens
A dislocated patella can occur either with a forceful
blow to the patella or from a twisting of the knee. Almost all patellar
dislocations occur laterally - this means that the patella dislocates
toward the outside of your knee.
If you play a
contact sport, you can suffer a dislocated patella if someone hits the
inside of your knee, forcing the patella to move too far to the
outside. This is not a very common way for this injury to occur, but it
can happen.
More common is a twisting of the knee
that causes the patella to dislocate. Remember the
quadriceps muscles
all attach to the patella. If these mucsles contract forcefully while
the knee is twisting, they can actually pull the patella out of its
normal groove.
One of the most common ways a
patella dislocation occurs is landing on the knee awkwardly, with a
sudden bending and twisting motion. This combination of bending and
twisting causes the patella to dislocate.
Signs
and Symptoms
The most obvious sign of a patellar dislocation
is the defromity. If your knee is bent, the patella will actually be
toward the outside of your knee.
It will usually
return to its normal place if you straighten the knee out. Sometimes
deformity is not noticible, especially if the patella dislocates and
then returns back to its groove right away.
Pain and
swelling are other symptoms of patella dislocation. You will usually
have pain along the inside of your knee, especiall along the patella.
This
is where the damage to the tissues occurs. Your knee will swell up all
around the patella, usually within the first few hours after injury.
Popping
or feelings of instability are also common with patellar dislocations.
Treatment
If
you suffer a patellar dislocation and your patella is out of place, the
first thing that you should do is to slowly and gently straighten out
your knee. This will cause the patella to return to its normal position
and will decrease your pain almost immediately.
Once your dislocation is
reduced, you should see your physician as soon as you can to have an
X-ray.
Fractures are not common with this injury,
but when the patella dislocates, it can damage the bone when it moves
out of or back into the groove.
Use the
R.I.C.E. principles for the first
few days after injury. Try to keep it elevated, rest, and use ice and
compression to help control your swelling.
Using a
knee brace for the first 2-3 weeks
is also important so that it limits the stress on the damaged tissues.
Your doctor may give you a straight leg brace, or a patellar
stabilizer.
Follow your physicians instructions so
that your patella and the damaged tissues will heal correctly.
Patellar
Dislocation Rehabilitation
Patella
dislocation is one injury that needs
supervised rehabilitation for the
best recovery. After your injury, you will have a lot of swelling and
pain, as well as decreased range of motion and strength. All of these
problems need to be addressed.
Rehabilitation with
a physical therapist or
athletic trainer will give you the
best chance for a full recovery, and it will significantly decrease the
chance of dislocating again.
Your rehab should focus
on improving your strength in your quadriceps, hamstrings, hips and
core, as well as restoring your range of motion.
Recovery
Time
Frame
Most patellar dislocations take awhile to
heal. The first 3-4 weeks are a protective phase to allow the tissues
to heal and tighten down. After that, strengthening can progress. You
should be back to normal in 3-5 months after your injury.
Some
patellar dislocations may require surgery to re-align the patella or to
repair the damaged tissues. Surgery is usually not performed unless
conservative rehabilitation fails.
Summary
A
dislocated patella is a serious sports injury that needs to be treated
by a
sports medicine professional for the best recovery. Intial treatment
focuses on the R.I.C.E. Principles as well as using a brace to protect
the damaged tissues. Rehabilitation will last for 2-3 months after
injury, and you should be able to return to sports in 3-5 months. If
conservative treatment fails, you may require surgery.
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