Recurrent Patella Dislocation
What is the Patella?
The Patella, often called the kneecap, is the bone on the front of the knee that protects the joint from injury. The Patella, attached by ligaments, acts as a floating shield that moves as we move the joint to keep the joint protected while allowing from complex movements.
What is Recurrent Patella Dislocation?
The patella being a floating bone bound by ligaments and seated in a bony groove, called the trochlea, can slip out of place and fail to do its job correctly, causing pain or reduced range of motion. There is the possibility that this can happen just once from trauma, but if the medial patellofemoral ligament (MPFL) is damaged then the Patella can continue to chronically displace. The chronic displacement of the patella is known as a recurrent patella dislocation. Recurrent Patella dislocation is a painful, and frustrating, condition that may require the services of a orthopedic specialist.
Symptoms of recurrent Patella Dislocation
- Increased rate of dislocation of the patella
- Instability of the patella causing a sensation that feels like the patella will dislocate again
- Swelling of the knee
- Pain around and in the kneecap
What are the causes of recurrent Patella dislocation?
There are many causes of a recurrent patella dislocation that separate into two camps. The first set of reasons that a patella will chronically dislocate is physiological:
- The patella can be naturally seated too high in the knee. This high seating in the trochlea is correlated with increased dislocations.
- The trochlea groove can be too shallow.
- The lateral ligaments that keep the patella centered could be too tight, or loose, on one side.
- The bones could be misaligned during development. Conditions such as knock knees can increase dislocations.
The other camp of causes for dislocation is Trauma:
- Dislocation from twisting
- Dislocation from bending
- Dislocation from impact
Unfortunately, every time a patella is dislocated the supportive tissues can be stretched, leading to increased rate of future dislocations.
What is the Treatment for recurrent patella dislocation?
Conservative treatment for recurrent patella dislocation
Conservative treatment for a patella dislocation that has only happened a few times is going to focus around protecting the joint with a splint, cast, or brace, as well as targeting the pain and inflammation. The pain and inflammation can be addressed with R.I.C.E., NSAIDs, and possibly steroids.
R.I.C.E.
- Rest
- Ice
- Compression
- Elevation
Following up with immobilization and reduction of inflammation, physical therapy may be considered to strengthen the knee. Strong knees are healthy knees. A physical therapy regimen may help prevent future dislocations, but if structure is too damaged then progression to surgical intervention may be considered.
Surgical treatment for recurrent patella dislocation
Surgical treatment for recurrent patella dislocations is going to start with a arthroscopy to assess and clean up any loose debris that may be causing issue. After assessing the situation the surgeon will move forward with a strategy that may include:
- If the MPFL (Medial patellofemoral ligament) is torn then it will need to be replaced with a tendon allograft or autograft.
- If the Patella is seating incorrectly then the surgeon may reposition the attachment of the tendon by cutting away bone and reconnecting it where it will properly align the patella.
- The trochlear groove may be deepened if needed.
- The ligaments may be tightened to properly balance the tension.
Recovery from recurrent patella dislocation correction
After correcting a recurrent patella dislocation the patient can expect to wear a brace and use crutches for weeks after surgery, followed with physical therapy to regain full range of motion, strength, and stability of the knee. Recovery should be complete in two to three months.
Suffering from recurrent patella dislocation? Get the Pro Sports Orthopedic team today! 817-375-5200
