Patella dislocation is a medical condition characterised by the displacement of the patella (kneecap) from its normal position in the patellofemoral groove at the front of the knee joint. This displacement typically results from a direct blow or a sudden twist of the knee, leading to pain, swelling, and an inability to straighten the knee. The condition often requires immediate medical attention to reposition the patella and rehabilitation to strengthen the surrounding muscles and prevent recurrence.

Symptoms Of Patella Dislocations

Symptoms of patella dislocation are typically noticeable and can include-

Visible Displacement of the Kneecap: The kneecap may appear out of its normal position, often shifted to the outside of the knee.

Visible patellar dislocation

Pain: Intense pain in the knee, especially during and immediately after the dislocation occurs.
Swelling and Tenderness: The knee area may become swollen and tender to the touch soon after the injury.
Difficulty Straightening the Knee: The knee joint may have less range of motion, making it challenging to straighten the leg.
The feeling of Instability: The knee may feel loose or as if it might give way when trying to stand or walk.
Popping Sensation: A popping sound or sensation might be experienced at the time of dislocation.
Change in Knee Shape: The knee might look deformed or distorted due to the displacement of the kneecap.

Patellar Dislocation

Diagnosis Of Patella Dislocations

Diagnosing a patella dislocation involves clinical assessment and imaging tests-

Medical History and Physical Examination: A healthcare professional will initially review the patient's medical history, including any previous knee injuries. The doctor will check the knee for indications of dislocation, swelling, discomfort, and range of motion during the physical examination.
Visual Inspection: The appearance of the knee can provide clues. A dislocated patella often causes a noticeable deformity – the kneecap may appear outside the knee.
Palpation: The doctor may gently feel (palpate) around the knee to determine the kneecap's exact position and assess for tenderness and swelling.
Movement Test: The patient might be asked to straighten or bend the knee to evaluate the range of motion and the stability of the patella.
X-rays: An X-ray of the knee can confirm the dislocation and show if there are any other injuries, such as fractures.

**A film x-ray of left knee lateral view shown fracture of knee cap(patella) bone**

Magnetic Resonance Imaging (MRI): In some cases, an MRI scan may be recommended. It can provide detailed images of the knee's soft tissues, including the ligaments and cartilage, which might be affected by the dislocation.
Computed Tomography (CT) Scan: Occasionally, a CT scan might be used to get a clearer picture of the alignment of the patella and the femur, especially if surgery is being considered.

Treatment Of Patella Dislocations

Treatment for patella dislocations typically involves immediate injury management and longer-term measures to prevent recurrence.

Initial Management

Reduction: The first step is repositioning the dislocated patella back into its normal place. This procedure, known as reduction, is often performed by a healthcare professional.
Immobilisation: After reduction, the knee may be immobilised with a brace or splint to keep it from moving and to allow the tissues to heal.
Ice and Elevation: The discomfort and swelling in the knee might be lessened by applying ice. It can also be advantageous to elevate the leg.
Medication: Over-the-counter pain relief medication such as ibuprofen can help manage pain and reduce inflammation.
Physiotherapy: After the initial healing phase, physiotherapy is crucial. Strengthening exercises targeting the quadriceps and hamstring can help stabilise the knee and avert further dislocations.
Range of Motion Exercises: Gradual exercises to improve knee flexibility and range of motion are typically recommended.
Activity Modification: During recovery, certain activities, especially those that put stress on the knee, may need to be limited or avoided.
Surgical Treatment: In cases where there are recurrent dislocations or significant damage to the knee structures, surgery may be considered. Surgical options can vary, from realigning the kneecap to repairing or reconstructing ligaments that support the patella.
Prevention Strategies: Future dislocation risk can be decreased by wearing appropriate footwear, using knee supports when playing sports, and keeping a healthy weight.
Long-term Management: Regular follow-up appointments and adherence to a physiotherapy programme are essential to ensure proper healing and reduce the risk of recurrence.

Conclusion

Patella dislocations, marked by a displaced kneecap causing pain, swelling, and movement difficulty, require prompt medical intervention. Diagnosis involves physical examination and imaging tests. Treatment includes realigning the kneecap, pain management, physiotherapy, and possibly surgery aimed at recovery and preventing future incidents.

FAQs About Inflammation: Patella Dislocations: Symptoms, Diagnosis & Treatment

Q1. How do you fix a dislocated patella?
A1. A patient who has a dislocated kneecap requires immediate emergency attention. The physician or other healthcare professional will straighten the leg and carefully slip the kneecap back into place after administering pain medication. We refer to this fast move as a reduction. They will next request an X-ray to look for any fractures.

Q2. What are the five types of knee dislocations?
A2. Usually, knee dislocations are categorised according to how much the tibia is moved about the femur. There are five primary forms of knee dislocations: lateral, anterior, posterior, medial, and rotational. Anterolateral, posterolateral, anteromedial, and posterolateral injuries are further classifications for rotary dislocations.

Q3. How serious is a patella dislocation?
A3. A dislocated kneecap damages your knee joint. It may damage the cartilage and raise the chance of osteoarthritis early in life. Recurrent dislocations will exacerbate the illness and complicate treatment.

Q4. What is the most common patellar dislocation?
A4. Acute patellar dislocations are often caused by trauma, either a direct blow to the medial portion of the knee or a non-contact twisting injury to the knee. A common mechanism is external tibial rotation when the foot is immobile.

Reference link:

https://my.clevelandclinic.org/health/diseases/21633-patellar-dislocations
https://www.physio-pedia.com/Patellar_dislocation