Knee Cap Dislocation or Patella dialocation is a common condition, especially among active individuals. It usually occurs as a result of sudden movement, overstrain or trauma. This can cause damage to the structures that provide stability to the knee joint, resulting in symptoms such as pain, swelling and restricted movement. Dislocation of the patella can seriously affect the normal function of the knee joint.
In this article, we will provide detailed information about dislocated kneecap. We will examine the symptoms of a dislocated kneecap, how it can be corrected and treatment options. We will also provide information about dislocated patella surgery.
Contents:
What is Knee Cap - Patella Dislocation?
In a dislocated kneecap, the normal movement of the patella is up and down, the kneecap does not move to the other side. However, there is no movement of the kneecap towards the inside or outside of the knee. However, it can move outward with an abnormal knee movement such as knee rotation. This is called kneecap-patella dislocation.
The kneecap (patella) is the most important structure that allows the leg to bend and straighten. However, the normal position of the kneecap is in front of the knee and articulates with the groove-like structure of the thigh bone called trochlea and moves up and down in the movements of bending and straightening the knee. In a dislocated kneecap, the kneecap protrudes outward from this groove (trochlea).
Why does the kneecap - patella come off?
Knee cap dislocation is most commonly seen as a result of rotation of the knee without contact during sportive activity. However, it can also occur after a direct trauma to the knee in contact sports such as soccer and basketball. The dislocation is almost always to the outside (lateral) of the knee. In some special cases, the kneecap may dislocate towards the inside of the knee. However, this is very rare and occurs in the womb.
The upper end of the kneecap is connected to the quadriceps tendon, the common tendon of the anterior thigh muscles. At the lower end of the kneecap is the patellar ligament, which connects it to the tibia. These tendons help keep the kneecap in place.
There is a very important ligament that prevents the knee from protruding outwards. We call this ligament the medial patellafemoral ligament (mPFL). One end of this ligament attaches to the upper and inner side of the kneecap and the other to the inner side of the thigh bone (medial femoral epicondyle).
In a dislocated kneecap, this ligament, the mPFL, often ruptures where it attaches to the thigh bone. This ligament often fails to heal properly after dislocation and poses a significant risk for recurrent dislocation of the kneecap.
In addition, in cases of dislocated kneecap, sometimes the kneecap may spontaneously snap back into place; if it does not, an orthopedic specialist should intervene and snap it back into place.
What are the Risk Factors for Knee Cap-Patella Dislocation?
Knee Cap Dislocation: One dislocation of the kneecap increases the likelihood of re-dislocation.
Patella Alta Positioning of the kneecap in a higher position than normal
Trochlear Dysplasia Reduced depth of the groove where the kneecap articulates with the thigh bone
Bony Angle Defects: Impaired hip, knee and ankle axis (deformities such as braces, crossed legs) and rotational deformities should also be considered. Such as increased hip anteversion.
Female Gender: As with anterior cruciate ligament injuries, acute patella dislocation is more common in women. This is thought to be due to the greater ligament elasticity in female patients.
What are the Symptoms of Patella Dislocation?
Patelladislocation, in particular, is a very painful and debilitating condition.
The most common symptoms of a dislocated kneecap are as follows:
Pain A dislocated kneecap is a very painful condition. The pain is not relieved unless the kneecap is put back into place.
Swelling When the kneecap is dislocated, intra-articular structures are damaged and bleeding occurs, which causes swelling in the knee.
Deformity There is an abnormal deformity. The kneecap protruding to the outside of the knee causes swelling in this area, and the front of the knee has a strange appearance because the kneecap is not in place. The kneecap protrudes to the outer part of the knee and prevents knee movement, so patients keep their knees in a bent position.
How to Fix a Dislocated Kneecap?
First of all, a dislocated kneecap is a very painful and painful condition. However, when the kneecap is dislocated, the ligaments and muscles in the joint can be strained or torn. This causes severe pain, swelling and limitation of movement in the knee.
In particular, a dislocated kneecap requires urgent medical attention. If the kneecap is dislocated, you can contact us through our communication channels. In addition, after the kneecap is replaced, imaging tests such as X-rays and MRI are performed to assess the damage to the joint.
Treatment for a dislocated kneecap varies depending on the degree of damage to the joint and the patient's medical history. Treatment options include:
Ice application: Ice can be applied to reduce swelling and pain in the knee. Ice can be applied several times a day for 20 minutes.
Pain medication: Painkillers may be prescribed to reduce pain and inflammation.
Knee brace A knee brace can be used to help hold the kneecap in place and stabilize the joint. The knee brace should be used as and when prescribed by the doctor.
Physical therapy Physical therapy may be recommended to restore the flexibility and strength of the knee joint. The physical therapy program includes exercises that strengthen the kneecap and increase the range of motion of the joint.
Surgical Treatment: If the kneecap dislocates frequently or there is severe damage to the joint, surgery may be needed. Kneecap dislocation surgery is performed to repair the ligaments and muscles that hold the kneecap in place.
How to Treat Patella Dislocation?
If the kneecap is dislocated, this is an emergency. The orthopedic specialist will put it back in place as soon as the knee x-rays are taken as soon as possible. When a dislocated kneecap occurs, there is a high probability of cartilage injury in the knee joint and kneecap. This is evaluated by X-rays, CT and MR imaging.
If there is no free cartilage in the joint, the patient is followed up with a knee brace that helps to hold the kneecap in place. Knee movements are started under the supervision of a physiotherapist.
It is also essential to focus on a closed chain quadriceps strengthening program and to start strength exercises including the core and hip area. If fluid accumulation occurs in the knee during this process, drainage of the fluid facilitates the physiotherapy process.
Is Surgery Necessary in the Treatment of Patella Dislocation?
If there is an intra-articular cartilage fragment, i.e. a loose body, or if there is an injury to the cartilage that requires intervention, surgery is essential, regardless of the number of dislocations and the age of the patient. Knee cap dislocation surgery and cartilage surgery are planned to be performed at the same time.
If there is no intra-articular cartilage problem, however, it can be predicted that the kneecap may dislocate again due to anatomical differences in the knee after evaluation of CT and MR imaging. In such a case, MPFL reconstruction and Fulkerson osteotomy surgeries are performed.
What is Recurrent Patella Dislocation?
If more than one dislocation of the patella occurs, it is called recurrent dislocation of the patella. The treatment of recurrent dislocation of the patella must be surgical, because with each dislocation, the intra-articular cartilage structure is further damaged. The patient should be evaluated in detail before surgery, the problems that cause dislocation of the kneecap should be determined and all of these problems should be aimed to be solved in a single operation.
Knee Cap Dislocation Surgery
Cartilage Surgeries: If there is a piece of free intra-articular cartilage, it should be evaluated with closed knee surgery (arthroscopic), and if it is a small piece, it should be removed, and if it is a large piece, it should be fixed with screws where it broke off. You can click on the link for detailed information about cartilage injuries and surgeries in the knee.
MPFL Reconstruction Surgery: After the cartilage damage is taken care of with closed knee surgery, it is necessary to reconstruct the ruptured mPFL in the same session. We call this procedure medial patellafemoral ligament reconstruction surgery. If you want to get detailed information about this surgery, you can click on the link.
Fulkerson Osteotomy Surgery: In addition, a special measurement is made in the preoperative CT scan evaluation. If the TT-TG measurement is more than 20 mm, it may be necessary to perform an operation called Fulkerson osteotomy. If you want to get detailed information about tibial tubercle osteotomy surgery, you can click on the link.
If you want to watch the knee cap dislocation surgeries performed by Op.Dr. Utku Erdem Özer, you can click these links:
MPFL Reconstruction Surgery:
Fulkerson Osteotomy:
How many days does it take to heal a dislocated kneecap?
In mild cases: If the knee cap is dislocated for the first time and there is no serious damage to the joint, the recovery time is 2-4 weeks.
In more serious cases: If the patella has recurred or there is severe damage to the joint, the recovery time can be 6-8 weeks or longer.
Patella Dislocation Surgery Patient Comments
Oguzhan A: Opr. Dr. Utku Erdem Özer and I felt very safe throughout the process. Thanks to his interest, openness and professionalism before, during and after the surgery, I went through the whole process smoothly and with understanding. My recovery period was shorter than I expected and thanks to the physical therapy program recommended by my doctor, I was able to return to my old activity level in a short time. I am grateful to him and his team.
Mehmet Y. : After consulting Opr. Dr. Utku Erdem Özer about the patella dislocation problem I have been experiencing for a long time, I decided to have surgery. Although it was difficult to decide on surgery, I realized that this process was the right decision thanks to my doctor's experience and approach. The postoperative recovery period was much better than expected and with little pain. Now I feel much better and I am happy to return to my daily life. I would like to thank Dr. Özer and his team.
Ayşe K. : Patella dislocation surgery was a big step for me and Opr. Dr. Utku Erdem Özer was a great chance for me to get through this process. I owe a lot to him for his extraordinary care, patience and information throughout the surgery and recovery process. The meetings I had with him before and after starting physical therapy made my recovery process much faster and more effective. Today, I have no trace of the pain I experienced before and Dr. Özer has a big share in this success.
Conclusion
A dislocated kneecap is a very painful and painful condition. When the kneecap is dislocated, the ligaments and muscles in the joint are strained or torn. This causes severe pain, swelling and restriction of movement in the knee.
A dislocated kneecap requires urgent medical attention. Once the kneecap is in place, imaging tests such as X-rays and MRIs can be performed to assess the damage to the joint.
Treatment depends on the degree of joint damage and the patient's medical history. Treatment options include ice application, pain medication, knee brace, physical therapy and surgery.
Surgery may be necessary, especially if a dislocated kneecap recurs frequently or if there is severe damage to the joint. Kneecap dislocation surgery is performed to repair the ligaments and muscles that hold the kneecap in place.
The recovery time after a dislocated kneecap varies depending on the degree of damage to the joint and the patient's medical history. In mild cases, the recovery time can be 2-4 weeks, while in more severe cases it can be 6-8 weeks or longer.
It is important to be patient during the healing process after a dislocated kneecap. It takes time for the tissues in the joint to heal. By carefully following the treatment prescribed by your doctor and actively participating in a physical therapy program, you can restore the function of your knee joint.
If you have any questions or concerns about a dislocated knee cap, you can reach us through our communication channels.
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