Knee cap dislocation or subluxation
This occurs when the kneecap (patella) moves out of its normal position, often described as the kneecap ‘”dislocating’’. Generally, the kneecap dislocates towards the outside of the knee.
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Synonyms for kneecap dislocation:
- Kneecap dislocation
- Kneecap that dislocates
Synonym for kneecap:
Patella
What is a kneecap dislocation?
This occurs when the kneecap (patella) moves out of its normal position, often described as the kneecap ‘”dislocating’’. Generally, the kneecap dislocates towards the outside of the knee.
If the kneecap moves completely out of its normal position, it is called a complete dislocation. If it moves slightly out of position, it is referred to as a subluxation.
What is the kneecap?
It is a bone referred to as a “sesamoid” bone because it is located within a tendon. The kneecap is located in front of the knee. Its main role is to allow the quadriceps tendon to have a greater lever arm for knee movements. Thus, the kneecap acts as a pulley for the quadriceps, enabling it to generate more force.
What are the symptoms of a kneecap dislocation?
The most common symptoms are:
- Obvious knee deformity following trauma (often the kneecap is seen on the side of the knee, forming a bump)
- Inability and pain when trying to extend the knee
- Swelling and pain in the knee
« In some cases, people will say that the kneecap relocated on its own by moving the knee after the accident. »
Many may experience the following sensations:
- Sensation that the knee is about to give way
- Sensation that the knee is unstable
What are the causes of kneecap dislocation?
Generally, kneecap dislocation is caused by trauma such as:
- Sudden twisting motion of the knee (like a sudden change of direction in soccer or football)
- A direct blow to the inside of the knee that forces the knee outwards
« If someone experiences regular kneecap dislocations, it is referred to as recurrent dislocation. In this case, even minor awkward movements can cause the kneecap to dislocate. »
How is a kneecap dislocation diagnosed?
Diagnosis is made through a review of symptoms and a clinical examination. If the injury occurred due to trauma, you should first see a doctor for an X-ray of the knee to ensure there is no fracture.
Did you know that physiotherapists can prescribe X-rays if the injury occurred less than 72 hours ago? If you don't have quick access to a doctor, you can get this prescription from a physiotherapist.
When should you see a physiotherapist for a dislocated kneecap?
You should consult a physiotherapist in the following cases:
- It's your first kneecap dislocation, and you've already seen a doctor and had an X-ray of your knee.
- It's your first kneecap dislocation, and you don't have quick access to a doctor, but you want to know what to do to help yourself immediately.
- It's not your first kneecap dislocation, and you want to avoid repeated dislocations in the future.
If you are unsure what to do, you can consult a physiotherapist who will guide you in the right direction. If they believe a consultation with a doctor is necessary, they will let you know.
What are the physiotherapy treatments for a dislocated kneecap?
If it's a first-time dislocation, the initial part of the treatment will often be guided by a doctor or an orthopedist (a doctor specializing in joints). There may be a period of wearing a knee brace.
Your physiotherapist will perform an assessment to determine the severity of the injury and any limitations. They will evaluate the following:
- Your joint mobility
- The gliding of your nerves
- The quality of your movements
- Your strength and stability
Based on the assessment results, your physiotherapist will:
- Mobilize your knee to reduce pain and improve your movement
- Give you specific exercises to retrain the control of your knee movements.
- Give you exercises to regain mobility, reduce pain and regain your muscle strength.
- Teach you how to properly manage your daily activities and hobbies to optimize healing
- Give you advice for your posture and movements.
What to do at home for a dislocated kneecap?
If this isn't the first time you've dislocated this kneecap, temporarily stop any painful movements and then gradually start doing them again.
If you have experienced trauma, you should first avoid doing anything that hurts while waiting to see a doctor or physiotherapist.
As with any traumatic injury, you should follow the PEACE and LOVE principles. Read the blog post about PEACE and LOVE (coming soon) and then read the advice here that applies to kneecap dislocation.
PEACE and LOVE advice specific to kneecap dislocation:
(make sure you have read the blog post that explains the PEACE and LOVE steps in detail)
For C = Compression:
Use a compression bandage or taping to wrap your knee.
For L = Load:
- Start walking and putting weight on the leg gradually without significantly increasing the pain.
- Wait until you no longer limp before increasing the duration of your walks.
For V = Vascularisation:
Light to moderate pain-free cardio activity speeds up healing. For a kneecap dislocation, you can:
- Do stationary cycling without pain
- Swim without pain
If you don't see any improvement after 10 days, you should consult a physiotherapist.
Sources:
- Petri M, Ettinger M, Stuebig T, Brand S, Krettek C, Jagodzinski M, Omar M. Current concepts for patellar dislocation. Archives of trauma research. 2015 Sep;4(3).
- Hayat Z, Case JL. Patella Dislocation.
- Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.
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