What It Is
Kneecap dislocation, also known as patellar dislocation, occurs when the kneecap (patella) moves out of its normal position in the groove at the end of the thigh bone (femur). This can happen due to trauma, injury, or in individuals with naturally loose ligaments. Recurrent kneecap dislocations can lead to a condition called patellar instability, where the kneecap is more prone to shifting or dislocating, causing ongoing pain and dysfunction.
Signs & Symptoms
- A visible displacement of the kneecap, usually to the outside of the knee
- Pain and swelling around the kneecap
- Difficulty or inability to straighten the knee
- A feeling of instability or the knee “giving way”
- Recurring episodes of kneecap shifting or dislocating with certain activities, such as running or pivoting
Diagnosis
To diagnose a kneecap dislocation or instability, Dr. Romanelli will perform a physical exam to assess knee alignment, range of motion, and stability. Imaging tests like X-rays or MRI may be recommended to evaluate any damage to the surrounding ligaments or cartilage and to determine the severity of the dislocation.
Treatment
Treatment for kneecap dislocation or instability depends on the severity of the dislocation and the underlying causes. In some cases, the kneecap can be manually repositioned (reduced) without surgery. However, for individuals with chronic instability or ligament damage, surgical intervention may be necessary.
Non-Surgical Treatment
For mild dislocations or those experiencing occasional instability, non-surgical treatments may be effective. These include:
- Rest and Ice: Reducing activity and applying ice to manage swelling and pain.
- Bracing: A knee brace may be used to help stabilize the kneecap and prevent further dislocations.
- Physical Therapy: Exercises aimed at strengthening the quadriceps and improving the alignment and stability of the kneecap can be highly effective in preventing future dislocations.
Surgical Procedure
In cases where the kneecap continues to dislocate or if there is significant ligament damage, surgery may be required. Medial Patellofemoral Ligament (MPFL) Reconstruction is a common surgical procedure used to restore stability to the kneecap. The MPFL, a ligament that helps hold the kneecap in place, is reconstructed using a tendon graft from the patient’s body or from a donor. This procedure significantly reduces the likelihood of future dislocations and improves knee function.
Physical Therapy
Rehabilitation through physical therapy is crucial for a full recovery following kneecap dislocation, whether treated surgically or non-surgically. Physical therapy focuses on strengthening the muscles around the knee, particularly the quadriceps, to support the kneecap and restore stability. Dr. Romanelli works closely with physical therapists to create a personalized rehabilitation plan to ensure a smooth recovery and prevent future instability.