If the patella has been shifted completely outside of its groove, the first step will be returning it to its normal position. This process is called reduction and can sometimes happen spontaneously. If not, a doctor can push the patella back in place. For patellar dislocations resulting in a damaged ligament, we will most often reconstruct the damaged ligament patellofemoral ligament surgically using a donor tendon. If there is damage to the articular cartilage in the joint, we can treat it arthroscopically.
Failure to address these issues may lead to a chronically unstable patella and potentially an arthritic knee. Rehabilitation following reconstruction of the patellofemoral ligament focuses on getting the patient fitter, faster, stronger with a primary emphasis on promoting proper tracking of the patella. During the first month, emphasis is on healing of the repaired ligament while maintaining range of motion as allowed by the patient's surgeon on an individual basis.
After the pain and swelling has gone down, your doctor may reassess the knee to determine if it needs reconstruction surgery to repair damaged tendons, ligaments and other soft tissues. In many cases, a dislocation injury will require surgery. First and foremost, you may need emergency surgery if damaged blood vessels are restricting blood flow to your lower extremities.
Second, you may need orthopedic surgery to address torn or damaged tendons, ligaments and cartilage around the knee. This surgery might not take place until several weeks after the initial injury, once the pain and swelling has gone down. Depending on the severity of the damage, you may require open surgery. Your long-term prognosis depends on the severity of the injury, the amount of damage you sustained and how quickly and effectively treatment was administered. Rehabilitation after a knee dislocation is slow, intensive and may last for up to a year.
Some people continue to experience pain, stiffness and loss of full range of motion in the long term. Unfortunately, your knee may never regain its full strength after a dislocation. If you play sports, you might not be able to perform at your prior level or your doctor might recommend not doing certain high-impact activities anymore.
Your doctor might also recommend wearing a supportive wrap during activities. The kneecap patella normally sits over the front of the knee. It glides over a groove in the joint when you bend or straighten your leg. When the kneecap dislocates, it comes out of this groove and the supporting tissues can be stretched or torn.
When a kneecap dislocates, it'll usually look out of place or at an odd angle. But in many cases it'll pop back into place soon afterwards. While you're on your way to hospital or waiting for an ambulance, sit still with your leg in the most comfortable position. If your kneecap has not corrected itself by the time you get to hospital, a doctor will manipulate it back into place. This is known as a reduction. Once the kneecap is back in place, you may have an X-ray to check the bones are in the correct position and there's no other damage.
However, it will be painful, swollen, and most likely unstable. Reduction, or repositioning of the injured joint, is crucial in order to reduce any pressure on the skin, blood vessels, and nerves in the affected area. These tests typically involve determining the stability and range of movement of specific parts of the knee.
Since a dislocated knee can cause potentially serious disruption to the blood vessels and nerves of the joint, your doctor will perform an examination to assess if injury to these structures has occurred. This exam may include:. Additionally, a technique called arteriogram may be used to assess blood vessel damage. It combines an injected dye and X-rays so your doctor can see how your blood flows through the arteries in your legs.
CKD is a rare condition in which the knee joint is dislocated at birth. Many factors have been suggested as causes. It may occur by itself or along with other developmental conditions, such as clubfoot. Doctors diagnose CKD after birth. It typically involves X-ray imaging of the affected joint. Treatment options can include serial casting or surgery. The first part of treating a dislocated knee is to be sure the kneecap is in its proper position. The process of moving the kneecap back into place is called reduction.
After the reduction, your leg will be placed in a brace to keep it stable and prevent the kneecap from moving again.
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