A physiotherapist will teach you some exercises to do at home to strengthen the muscles that stabilise your kneecap and improve the movement of your knee. The splint should only be kept on for comfort and should be removed to do these exercises as soon as you're able to move your leg.
It usually takes about 6 weeks to fully recover from a dislocated kneecap, although sometimes it can take a bit longer to return to sports or other strenuous activities. Most people who dislocate their kneecap will not dislocate it again. But in some people it can keep happening. This often happens if the tissues that support the kneecap are weak or loose, such as in people with hypermobile joints , or because the groove in the bone beneath the kneecap is too shallow or uneven.
Regularly doing the exercises your physiotherapist recommends can help strengthen the tissues that hold the kneecap in place and reduce the risk of dislocating it again. Surgery may occasionally be needed if the kneecap keeps dislocating. A common procedure is a medial patellofemoral ligament MPFL repair. Read About Acute Patellar Injuries. It can occur as a result of direct, forceful trauma or due to movement putting excessive pressure on the kneecap, making it a common injury among athletes in sports such as football, basketball, lacrosse, or soccer.
When a kneecap is dislocated, it is common for other parts of the knee to be injured as well; for example, meniscus tears or anterior cruciate ligament ACL tears often occur at the same time as the dislocation.
Once it is jolted out of the groove that it normally sits in, the dislocated kneecap can move to either side of the knee, but more frequently will dislocate to the outside of the joint. A dislocated kneecap is not to be confused with a dislocated knee. In these situations, to limit the amount of lost time in competition and to reduce the chances for cartilage lesions on the undersurface of the patella—which often are non-repairable—patellar stabilization procedures are appropriate.
These procedures can be either soft tissue or bone procedures, or a combination thereof. It has been found in retrospective studies that the incidence of recurrent dislocation after the first dislocation occurs can be as high as 40 percent. Surgically treating those dislocations by lessening lateral tension and tightening medial restraint could reduce this recurrence rate to below 10 percent. Surgical procedures on the patella are usually done in the outpatient setting.
Procedures limited to altering soft-tissue tension begin rehabilitation within a week and return to activity can be expected as early as six weeks.
Procedures that require bone work osteotomies require a period of relative immobilization and need 10 to 12 weeks before a return to athletic activity is permitted. Patellar Dislocation. Typical symptoms include: Rapid, acute swelling. Figure 3: Visible lateral deviation of the patella. Credit: Radiographics. The patella acts as a lever arm connecting the quadriceps muscles via the quadriceps tendon to the tibia via the patellar tendon.
Patellar instability can be derived from any anatomical change in the patellofemoral joint. The vastus medialis obliquus muscle and medial patellofemoral ligament MPFL are responsible for much of the medial stability of the patellofemoral joint by counteracting the natural lateral glide of the patella see Figure 1. The primary stabilizer ligaments of the posterolateral corner are the popliteus tendon, fibular collateral ligament, and popliteofibular ligament.
Both the long and short head of the biceps femoris muscle act as secondary stabilizers here.
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