Patellar dislocation or instability is usually a bigger problem in women than men and tends to occur more often in athletes. An orthopedic doctor can help with stability issues in the knee, which can prevent further dislocations. After the first dislocated kneecap, there is a 40% chance of a re-occurrence, so it is important to take preventative measures.
How Dislocation Occurs
There are two types of patella dislocations that can occur. A proper dislocation is when the patella is out of position and stays there until a doctor is able to relocate it. A subluxation occurs when the kneecap moves out of its proper position and back again almost immediately.
In many cases, patellar instability or dislocation occurs when there is a sudden twist in the leg that causes injury, or when the muscles are weak. Sports are commonly the cause of trauma, or other exercises that put too much stress on the knee. A sudden blow to the knee may also knock the kneecap to one side.
Immediate attention is required in the case of a dislocation, to move the bone back into place. The leg will then need to be rested for several days. The patient can take steps to prevent further problems.
Get Sufficient Rest
If the patient has experienced a patellar dislocation, it is essential to rest the joint for at least a week. A medical consult is highly recommended before returning to regular activities. It can take up to six weeks for the knee to be fully recovered and the patient should not return to sports until a doctor has given the all clear.
Use a Brace
A proper knee brace can lend support to the kneecap and surrounding area, preventing another dislocation. There are a number of braces on the market and an orthopedic doctor can help patients find the best one for their needs. The brace type will depend on the severity of the kneecap instability. The brace should be used for all strenuous activities that could stress the knee.
Strengthen the Knee and Leg Muscles
Ongoing exercises are essential to strengthen the leg muscles. Most physical therapists will also work with the patient to improve hip strength as a poor walking gait can put the knee at risk.
Stretches are particularly important, before sports or any other activity that requires putting pressure on the knee.
In some cases, surgery is necessary. If the kneecap is too twisted and the ligaments have been stretched beyond repair, surgical intervention may be necessary. Multiple dislocations may also warrant surgery. The surgeon will do several tests to gauge what exactly is going on in the joint and then open up the knee to repair or rebuild the MPFL and realign the kneecap. In cases where the tibial tubercle is drastically rotated, it may be moved and screwed into place. It can take some time and physical therapy to recover from this type of surgery.
Surgery is also necessary when there are loose pieces of cartilage or bone inside the joint. These can cause further damage and need to be removed in a relatively simple procedure. The recovery for this type of intervention is usually fairly quick and easy.