The main methods can be remembered by the mnemonic RICE:. Following treatment of the dislocated kneecap, most people will benefit from a course of physical therapy and rehabilitation to help strengthen the muscles around the knee and improve the outcome. If you experience any symptoms of a dislocated kneecap, such as feeling the knee give way, severe knee pain, an inability to bend the knee, or an abnormal location of the kneecap, you should go to your physician or emergency department.
A physician can examine your knee to see if you have a dislocated kneecap and help return the kneecap to its proper position. Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions. Questions may relate to diseases, illnesses, or conditions you may have or that may run in your family. Your answers will help us provide you with medical information and identify services that may be relevant to your health.
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No Ads. Tom Liu, MD. Ophthalmology Resident, University of Pennsylvania. Jeffrey M. Last updated October 1, Heart Icon.
Speech Bubble Icon. Share Icon. Facebook Icon. LinkedIn Icon. Pinterest Icon. Pocket Icon. Most kneecap dislocations will go back into place on their own, but if not, they are treated with prompt reduction repositioning of the kneecap.
Most patients will go to the emergency room, and while repositioning the kneecap is relatively straightforward, pain and muscle spasm can prevent this from being easily accomplished. Therefore, anesthesia either local or general may be administered to help reposition the kneecap. Most kneecap dislocations can be repositioned by simply straightening the knee once control of the pain and spasm allows.
After repositioning the kneecap, treatment usually begins with R. While preventing weight on the leg may help with pain, it is not necessary to keep all weight off of the leg. Once the acute swelling has subsided, treatment may progress. The next phase of treatment usually consists of physical therapy and bracing the kneecap. As discussed earlier, kneecap dislocations can become a recurrent problem.
In patients who have recurrent repeat dislocations, there are surgical options. The usual treatment is to reconstruct the ligament that pulls from the inside of the kneecap to keep in place. In some circumstances, a realignment of the extremity, involving cutting and repositioning bone, may be recommended. Recent interest has developed in preventing these recurrent dislocations. Each time the kneecap dislocates, the cartilage can be injured, and the ligaments can become more stretched out.
Concerns about increasing the likelihood of arthritis development from repeated trauma have made some doctors more aggressive in trying to prevent repeat dislocations. Some surgeons are trying to restore the normal anatomy by repairing the MPFL after a first-time dislocation. Surgery after the first dislocation is controversial because not all patients who dislocate their kneecap will have another dislocation.
In addition, early surgery has not been shown through scientific study to be helpful in preventing arthritis. If your surgeon is recommending surgery, and you are unsure to proceed, it never hurts to seek out another opinion. Just remember: there is not always a right and a wrong answer. While some surgeons and patients may have strong opinions, there is not always a clear answer as to how to best proceed. It never hurts to seek out some other advice.
Philadelphia, PA: Elsevier; chap Patellar instability. Updated by: C. Editorial team. Kneecap dislocation - aftercare. A kneecap that slides out of the groove partway is called a subluxation.
A kneecap that moves fully outside the groove is called a dislocation. More About Your Injury. A kneecap can be knocked out of the groove when the knee is hit from the side. If tests show that you do not have damage: Your knee may be placed in a brace, splint, or cast for several weeks. You may need to use crutches at first so that you do not put too much weight on your knee.
You will need to follow up with your primary care provider or a bone doctor orthopedist. You may need physical therapy to work on strengthening and conditioning. Most people recover fully within 6 to 8 weeks. If the injury is minor, the doctor may recommend ways to protect the knee as the body heals on its own with time. It is uncommon to need surgery after a first-time dislocation of the kneecap, but surgery may be necessary if the injury is severe or there is a high risk of repeat dislocations.
This minimally invasive procedure involves inserting a camera and surgical tools through small incisions around the knee.
With their tools, the surgeon assesses the extent of the damage and may be able to perform repairs. A review notes that surgeons most commonly perform reconstructive surgery to repair the medial patellofemoral ligament, which attaches the inside of the kneecap to the long bone of the thigh. This, the most involved and complex type of surgery for recurrent kneecap dislocations, involves cutting away a piece of the shin bone, or tibia, and moving it to a position that improves the stability and alignment of the kneecap.
The surgeon may then insert screws to help keep the transferred bone in place while it heals. Anyone who has dislocated their kneecap is at risk of the injury happening again.
The risk of a recurrent dislocation increases if the body has not had enough time to recover fully from the initial injury. A review observes that surgical treatment may be a good option for people with a first-time dislocation who have a high risk of recurrence.
However, it is important to keep in mind that surgery can also increase the risk of other knee issues, such as arthritis. The doctor may recommend a brief period of immobilization in a brace to allow the knee to rest and to prevent further injury.
The researchers behind a study recommend immobilizing the knee for 2—3 weeks , but the right amount of time depends on the injury. Doctors also usually recommend physical therapy to help regain the range of motion and strengthen the muscles that support the knee.
This also helps to reduce the likelihood of recurrent dislocation.
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