Patella dislocation

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What is it about ?

The kneecap (patella) is located at the front of the knee and is part of the knee joint. It is as if hooked in the tendons of the thigh muscles. When you bend your knee, muscles and tendons tighten and force is exerted on the kneecap. The pressure decreases again when you straighten your leg. A trauma (injury or injury following an accident) is always the cause of a dislocation: too much force is exerted on the kneecap, forcing it to move outward. This is what usually happens when the knee is flexed in external rotation.

How to recognize it?

A sharp pain appears immediately after the dislocation. This explains why the person cannot lean on his legs well. Climbing stairs, or any other load on the knee becomes painful. The knee swells almost immediately from the blood flowing into the joint. Full flexion and extension becomes impossible. The person hurts when pushing on the inner side of the knee. It happens that we notice at first glance that the patella is displaced. As you press the kneecap outward, the pain you feel causes you to instinctively contract the quadriceps.

How is the diagnosis made?

The doctor can usually make the diagnosis based on a physical examination of the knee. He always requests an x-ray of the knee, as this type of trauma is often accompanied by a fracture of the kneecap, tibia or femur.

What can you do ?

If you cannot fully straighten the knee, support it with a pillow. Put an ice pack on it. Avoid overloading it.

What can your doctor do?

In case of slight swelling and bearable pain in the knee, the doctor will prefer to wait. Sometimes he prescribes a splint (stabilization orthosis) that supports the knee joint. Sometimes the trauma heals spontaneously. Muscle strengthening exercises at the physiotherapist can be helpful.

If the knee is badly swollen, the doctor will puncture the blood from the knee. Sometimes droplets of fat are observed in the punctured blood, which always indicates the presence of a fracture.

If the dislocation returns regularly or in the event of a very serious dislocation, the doctor plans an operation: the surgeon fixes the kneecap and evacuates all the small bone debris.

Want to know more?

Source

Foreign clinical practice guide ‘Patellar luxation’ (2000), updated on 06/26/2017 and adapted to the Belgian context on 06/10/2019 – ebpracticenet

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