According to The Royal Children’s Hospital Melbourne, patella (kneecap) dislocations usually occur in physically active children aged 10-17.[1] Yearly statistics from the Australian Institute of Health and Welfare showed that 1,131 patients presented to Australian hospitals with a dislocated patella injury during the year.[2]
Other more specific classifications of patella (kneecap) dislocation injuries are more accurate in describing certain circumstances. For instance, patella subluxation refers to an injury where the kneecap temporarily slides out of its normal positioning before returning. Recurrent patella dislocations occur when the injury happens more than once.
Read on to understand what you should know about patella (kneecap) dislocations and knee pain; the risk factors, treatment options and expected recovery time.
What is a Patella Dislocation?
Patella dislocation is a painful knee injury that occurs when the patella (kneecap) pops out and slides out of the trochlear groove (the space where the kneecap usually sits). Most dislocations occur with the patella visibly moving out to the outer side of the knee.
What are the symptoms of patella dislocation aka kneecap dislocation?
The primary symptoms of a patella dislocation are a "popping" sensation when the injury occurs, followed by severe knee pain, sudden swelling and an inability to weight-bear, walk or straighten the knee.
Common symptoms of a patella dislocation
What causes patella dislocations?
Kneecap dislocation is caused by either a blow to the knee directly, most common in sports, or a sudden change of direction with the affected leg planted on the ground. This increased pressure on the ligaments supporting the knee cap causes them to tear and allows the kneecap to become dislocated.
Common causes of patella dislocations
Sports that increase the risk of a patella dislocation
Physical activities that involve twisting or a sudden change in direction can lead to patella dislocation.
-
Dancing
-
Basketball
-
Football
-
Soccer
-
Tennis
-
AFL
-
Netball
How is a kneecap dislocation diagnosed?
A patella dislocation causes knee instability and can limit the quality of your life. Impairments in your ability to walk can happen for a long time if not adequately addressed.
It is best to seek medical attention immediately if you have dislocated your patella.
In Australia, the best solution is to immediately seek help from your GP or the emergency department, as they can help relocate your patella to the correct place.
Sometimes through movement, the patella will relocate on its own, and you will be able to move freely again.
In either case, unfortunately, this doesn’t mean everything is OK, and you can go back to what you were doing. You will need some rehabilitation to ensure the knee is strong, stable and there is nothing else wrong with the knee joint.
There are several options available when it comes to diagnosing your patella dislocation. One of the more common and most recommended by Australian GPs is an assessment from a physiotherapist.
Physiotherapists are rehabilitation experts that deal with sports injuries such as patella dislocations. They are in the best position to diagnose and treat your condition.
The rehabilitation process begins with a few questions about your injury and any other relevant medical information. Make sure you tell the physiotherapist as much as possible, this will help with an accurate diagnosis.
After establishing a background of your injury, your physiotherapist will perform a physical assessment to check the integrity of your patella and screen for other possible injuries that may be causing your pain and symptoms.
Your physiotherapist will then create a specific treatment plan for you and will guide you through your recovery.
This will also include:
-
A detailed treatment plan to manage your pain and help you regain function
-
Home exercise programs to support your treatment
-
Target goals and recovery time
-
Professional guidance and advice to maximise your recovery.
How is a patella dislocation treated?
A patella dislocation can make your knee unstable and limit your overall mobility. Most patella dislocations can be relocated through manual manipulation by a trained health professional. However, damage to the soft tissues around the knee can persist and can require rehabilitation.
There are several options when it comes to treating patella dislocations. One of the more common and the treatment option referred to by Australian GPs the most frequently is physiotherapy.
Patella dislocations are common sports injuries routinely encountered by physiotherapists. They are the most qualified to treat and give quality care to help you recover from your injury.
The primary focus of your treatment will be to reduce the signs of inflammation and improve the knee’s stability. Your treatment will also address any impairments that will likely reinjury in the future.
Depending on the severity of your patella dislocation, a physiotherapist may provide you with a combination of the following types of treatments:
-
Reduction of Dislocation - First things first, your patella must be relocated. This can occur naturally when you bend your knee, or sometimes you may need to go to the emergency department for relocation.
-
Manual Therapy - Hands-on techniques your physiotherapist uses to improve the range of motion in your knee and reduce soft-tissue inflammation.
-
Taping - Specialised taping techniques to reinforce the stability of the patella and prevent re-dislocation.
-
Stretching Exercises - Used in the later stages of your recovery to prevent stiffness and improve your range of motion.
-
Strengthening Exercises - Exercise techniques to strengthen the muscles to improve the knee joint stability and biomechanics.
-
Therapeutic Exercises - Exercise techniques to correct impairments and support your recovery.
A typical physiotherapy session with your local physiotherapist will last anywhere between 30-60 minutes. It is not uncommon for patients to feel the benefits in just one session.
Next step - Creating a treatment plan made for you
After your assessment, a detailed treatment program will be given to you to allow proper healing of your knee and help you regain your function.
Self-care for your patella dislocation
If the dislocation is less severe, the knee cap may be partially dislocated before shifting back to its original position. In which case, you can immediately begin treating it yourself to limit pain and injury.
If you have a dislocated patella, here are the best things you can do and avoid.
Things to do:
- Rest
Take a break from physical activities that can affect the knee joint. Dislocation of the kneecap damages the soft tissues in your knees and requires proper healing time.
- Ice
Apply ice for 15 minutes to the knee immediately. Do this several times a day.
- Compression
Use a compression bandage to ease the swelling and provide additional support to the knee.
- Elevate
Elevate the knee so that it is a few degrees above the heart to reduce swelling.
- Crutches
Use an assistive device to take the weight off the knee and assist your mobility.
- Brace
Use a prescribed brace to limit the movement and stabilise the knee joint while it is still healing.
Things to avoid:
-
- Avoid wearing high-heeled shoes.
Wearing high-heeled shoes puts excessive stress on your joints.
-
- Avoid high impact activities.
Take a break from physical activity for a few weeks or until you have a clearance from your physiotherapist or doctor.
Do I need a specialist or surgery?
Dislocation of the patella needs to be reduced either manually or through surgery to put it back to its original position. This is usually done by a doctor in an emergency.
Diagnostic imaging may be done to check for the integrity of the structures of your knee joint. Fractures and ligament injuries are usually associated with complete patella dislocation.
-
MRI: An MRI can be done to check the status of the patella ligaments, which provides stability to the kneecap.
-
X-ray: A plain radiograph can scan for fractures on the femur (thigh) parts around the knee joint.
Surgery may be required if the patella dislocates multiple times and continues to be unstable despite therapy and bracing.
Your GP may coordinate with your physiotherapist to rehabilitate your knee and ensure your proper recovery.
What is the recovery time / prognosis for patella dislocation?
Ultimately, recovery time is dependent on being proactive and seeking professional treatment along with the severity of your kneecap dislocation.
People who suffer from a patella dislocation are expected to make a full recovery within six weeks, depending on the severity of the injury.
However, returning to sports and other high-impact injuries may take longer and require your physiotherapist or medical doctor clearance.
Physiotherapy can accelerate your healing time and allows you to regain your normal function through extensive rehabilitation and therapy.
Can patella dislocations be prevented?
It is very difficult to guarantee the prevention of a dislocation. However, there are some things you can do to reduce the risk, and perhaps avoid re-occurrences in the future.
-
Stretch regularly – Stretching the muscles of your legs, thigh and hips can effectively reduce the tightness of the muscles that act on the knee.
-
Strengthening exercise – Regular strengthening exercises that target the muscles of the quads, hamstrings and glutes can help you prevent injuries to the knee.
-
Wear athletic shoes – Wearing proper athletic shoes can prevent over-pronation of the foot during running which may decrease the risk of patella dislocation.
Outlook and the main takeaways
The kneecap is a vital component of your knee joint that allows a smooth transition of movements. However, patella dislocation can make the knee unstable and limit your overall mobility.
Comprehensive therapy and immobilisation is the key to treating patella dislocation. Book a consultation with a physiotherapist today to improve the outcome of your patella dislocation.
Anatomy of the knee
The patella or kneecap is located in front of the knee joint. It is attached to the quadriceps muscle via the quadriceps tendon and lies on the patellofemoral groove.
The patella functions as a protective bone and lever for the quadriceps muscle when bending and straightening the knee.
The overall stability of the patella greatly relies on the tendons and ligaments that are attached to it and also on the projections of the femoral condyle.
A direct blow to the knee or excessive rotation on a planted foot can dislocate the patella and may damage the medial patellofemoral ligament.
