A dislocated kneecap can be a very painful medical condition, usually resulting from a force related injury. There are many different causes for a dislocation, and only a diagnostic work up by a qualified physician will accurately be able to tell you the best course of treatment. Sometimes the knee can be slid back into place and sometimes surgical intervention is required.
The job of the kneecap is to protect the knee joint. It is held in place by ligaments and tendons in order to stave off any potential threat to the knee joint. When it slides out of place, this is a dislocation.
There have been cases of dislocated kneecaps that come from nothing more than the design of the leg. When a leg is misaligned the kneecap can slide out of place on a regular basis, causing excessive pain, swelling, bruising, and ultimately an inability to walk.
Common Causes of a Dislocated Kneecap
Some of the most common causes of a dislocated kneecap include forcible dislocation, which is usually the result of some sort of accident. Force applied to the top or the bottom of the leg can move then kneecap out of place.
Worn ligaments can also move the kneecap out of place. If a ligament is too long it will allow for excessive sliding of the cap, which means that eventually the kneecap can slide entirely off of the joint. In most cases, pain brings the patient to the doctor before this happens and a simple surgical procedure can shorten the length of the faulty tendon and bring the kneecap back into place.
The force applied to the leg can often be of a twisting, direct pressure, or impact nature. The farther down the leg the pressure, impact, or twisting takes place the more likely a dislocation becomes. This is because the leg is constructed with an inherent balance point and the tibia bone increases leverage.
Diagnosis of a Dislocated Kneecap
The obvious disfigurement of a dislocation makes diagnosing the problem relatively straightforward. Some physicians will insist on taking x-rays or performing an MRI to rule out kneecap damage and other possible complications. Kneecaps that regularly fall out of place require an MRI to diagnose the cause of the chronic subluxation. The main difference between a subluxation and a dislocation is the return of the kneecap to its rightful place. A knee that is temporarily dislocated but slides back into place is known as a subluxing knee.
Treatment Options for a Dislocated Kneecap
There are a variety of treatment options that a physician will order as appropriate for a dislocated kneecap. Once the knee has been returned to its proper position an immobilizer is often ordered to allow the ligaments to heal. This device usually goes from the ankle to the upper thigh and prevents the patient from bending the knee. Stabilizing the knee in this manner often helps to increase the potential for a full recovery.
Physical therapy is often ordered to help increase muscle strength and prevent a subsequent dislocation. These exercises target the muscles that surround the knee and help prevent further injury to the location.
If physical therapy does not readily solve the problem after a period of immobilization additional tests are often ordered so that the physician can determine whether a surgical option is appropriate. Surgical options can range from minor to severe.
Minor surgeries are done as an arthroscopic procedure. This helps to increase healing time and then promotes use of the leg after surgery. Major surgeries, such as a full leg realignment, can be highly intrusive. This involves open knee surgery and cutting the tibia apart in order to reattach it in a more aligned position to keep the knee in a more stable position. Some patients do very well after knee surgery while others tend to suffer a great deal. A small percentage of patients never fully recover and can have a lifetime of limitation and pain.
Patients should discuss and explore all options with a surgeon before opting for a surgical procedure. The knee is a complex joint and can take many months to heal. Rushing into a surgical option can cause more problems than it solves if the surgery wasn't required in the first place.
Preventing a Dislocated Kneecap
It's not easy to prevent a dislocation of the kneecap, especially when sports and active lifestyles are common. However, keeping a knee stabilized through bracing and wrapping can help increase the resistance level to dislocating and help decrease the likelihood of a serious incident.
Talking to a physician about the kinds of activities that you participate in can also help decrease the likelihood of a dislocation, especially if one has already happened. Some sports and activities are more likely to result in a dislocation than others and preventative measures are necessary in order to keep the knees healthy and pain free.