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Who Is Particularly at Risk of Patellar Dislocation?
Factors that predispose an individual to patellar dislocation include:
- Joint hypermobility
- Genu valgum (knock-knees), where the knees angle inward in a standing position
Ligament injuries are the most common accompanying damage. Athletes participating in sports requiring speed and sudden rotations in the knee joint—such as basketball and soccer players—are also at higher risk. These athletes should be particularly cautious and employ proper techniques during play.
Patellar dislocation can also result in damage within the knee joint itself. The most severe of these are articular cartilage injuries, which can influence the development of osteoarthritis later in life. Therefore, treating every patellar dislocation is essential, and a thorough diagnostic evaluation should follow each incident to avoid overlooking injuries that may lead to more serious complications in the future.
Symptoms of Patellar Dislocation
In cases of traumatic patellar dislocation, there is a noticeable sensation of the patella shifting to the side, usually outward. This is often visibly apparent. In some cases, the patella spontaneously returns to its original position, while in others, gentle manipulation or movement of the knee may be required. However, the patella should never be forced back into position.
If a patellar dislocation occurs, it is advised to call emergency services and proceed to the nearest emergency department.
Diagnostics
This injury is visually apparent and does not initially require imaging to confirm the diagnosis. Diagnostic tools are later employed to assess any additional damage to the knee.
Treatment of Patellar Dislocation
The first dislocation is typically treated conservatively, as the risk of recurrence is only about 15%. However, the risk increases to 90% after a second dislocation, making surgical intervention a likely course of action. Rehabilitation is also critical, as it helps to strengthen the muscles surrounding the joint.
In surgical cases, the most common procedure performed is reconstruction of the medial patellofemoral ligament (MPFL), which stabilizes the patella. Hospitalization after the procedure usually lasts one day. Patients are required to use crutches for approximately three to four weeks. Recovery to normal daily activities takes about two months, while returning to sports typically takes around six months.
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