Patellar Dislocation

Patella dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. The most common direction for the kneecap to dislocate is laterally or the outside. This is commonly associated with pain and swelling in the soft tissue tissues which may have been stretched or damaged. Patella subluxation refers to when the kneecap is only partially displaced and then returns to it’s normal location.

• Pain and swelling around the knee cap.

• At the time of injury you may notice an audible ‘pop’.

• You may be unable to straighten or bend the knee and walking will be painful.

• Observable deformity in a dislocation with the knee cap having migrated from it’s usual position.

This injury is commonly caused through trauma, either with a twisted knee or a direct blow to the front of the knee. This is likely to cause a significant amount of pain and the patient is unable to carry on with their sports and is advised to attend A&E.

However, in people who are very flexible/hypermobile or have a shallow joint, the patella can dislocate more regularly and with far less trauma and often these patients are able to manage this without requiring a trip to hospital.

Patellar subluxation is far more common and can be due to factors such as tight structures on the outside of the knee, weak structures on the inside of the knee, poor tracking of the kneecap through its groove or previous injury. The most common group to suffer Patellar dislocations are athletic teenagers.

Pivoting your femur (thigh bone) inwardly whilst the foot is fixed to the floor and with the knee bent is the most common dislocating movement (Greiwe et al., 2010)

Your Physiotherapist will take a history of your injury followed by a comprehensive clinical examination to provide you with a precise and accurate diagnosis. Timely diagnosis will ensure the most effective treatment and management can begin, helping to facilitate a speedy recovery. Your Physiotherapist will work with you to develop goals based on what is important to you and regular re-assessment will ensure you are making progress towards those goals.

Your Physiotherapist will educate you on your injury and discuss ways in which you can help to reduce your symptoms and support your recovery. In the early stages following injury, your Physiotherapist may recommend relative rest alongside the use of ice, compression and elevation to help manage the swelling. They may also discuss over the counter pain relief to further help reduce your discomfort.

Most patients do not require surgery and strengthening the muscles around the knee and at the top of the leg are vital to reduce the chance of any further dislocations. This is done in a graded way to help you to gradually build the muscles in a way that is manageable for you and doesn’t significantly overload these muscles. Your Physiotherapist will also work on strengthening your core musculature and around the top of the legs which all play an important part in how your knee cap moves up and down at the front of your knee.

Our skilled Physiotherapists at Pure can work with you to develop a personalised activity programme and strength training protocol to effectively progress you through your rehabilitation and restore your function and help you return to activities and sports you enjoy.

In some cases, the patient may require an operation to repair injured ligaments following the dislocation followed by a period of time in a brace. During this time rehabilitation can start to restore normal movement and start to strengthen muscles around the knee.