Treatment for Dislocated Knee Cap in Kirkland, WA

What is Patella Instability?

Patella instability occurs when the kneecap moves out of position or dislocates– usually to the outside of the knee. This can occur from an injury, or in some cases, people who are predisposed can have their patella dislocate with normal activity. If left untreated, the likelihood of permanent damage and even more pain could increase.

Dr. Camille Clinton is a fellowship-trained board-certified orthopedic knee surgeon specializing in treating patella instability. Dr. Clinton believes that every patient’s situation is unique and will take the time to discuss treatment options and find the right one for you.  Call (425) 899-4810 to schedule an appointment at her orthopedic surgery office in Kirkland, WA today!

What Causes Patella Dislocations?

The kneecap is normally held in position by the bones, ligaments, and muscles around the knee. There is a groove, called the trochlea, in which the kneecap sits while the knee is bent.  A ligament, called the medial patellofemoral ligament (MPFL), attaches the kneecap to the inside of the femur and is critical for holding the kneecap in position. The muscles around the knee, especially the inside of the quadriceps or VMO, also help hold the kneecap in position and help with kneecap tracking.  Multiple factors predispose people to patella dislocations including, prior trauma, high-riding knee cap (patella alta), shallow trochlea, loose ligaments and lower extremity alignment.

There are two common ways this injury occurs:

During an accident

Also known as a traumatic event, the kneecap can slip out of place if you or your child has suffered from a hard blow or fall. The injury is more common in children who play high-contact sports, such as football. During the accident, the kneecap may slide out of place quickly and go back into place on its own immediately after it slides out. There may be a lot of pain in your knee and swelling in front of the knee after this happens, making it necessary to seek medical treatment. Dr. Clinton will be able to determine if the patella is completely or partially dislocated.

The kneecap dislocates by itself

Also known as an atraumatic event, meaning no specific injury has taken place. When your child’s patella slides out of the groove on its own, that usually means that the groove may be too shallow or the patella is misaligned. There is a chance that dislocations can take place once in a while or very often. If the injury persists, then damage to the kneecap and the end of the thigh bone could arise.

What are the symptoms?

The symptoms associated with patellar instability vary because it solely depends on how much the patella has moved out of place and the extent of the damage done to the knee. Some of the more common symptoms include:

• Pain and swelling in the knee
• Pain when sitting
• Feeling a shift of the kneecap
• Creaking sounds upon movement of the knee
• Stiffness in the knee

Kneecap Dislocation Treatment

Initially, treatment for a patellar or kneecap dislocation usually involves bracing and physical therapy to work on strengthening. When patellar dislocations become recurrent they cause functional limitations and they can even cause cartilage damage. If there is cartilage damage associated with a patella dislocation and/or there are recurrent dislocations, surgery is usually recommended to prevent further damage.

MPFL Reconstruction

The medial patellofemoral ligament or MPFL is the main soft tissue restraint to patella dislocation. When a patella dislocation has occurred this ligament is usually torn or stretched out. Reconstructing the MPFL can stabilize the kneecap. During this surgery, the knee is inspected arthroscopically. Following this, a tendon graft is placed between the medial epicondyle on the femur and kneecap. This procedure has been proven to be very successful in treating recurrent patellar instability. Patients are usually braced for 6 weeks after surgery and are able to return to sports in 4 to 6 months.

In some patients, if there is abnormal bone alignment predisposing to patella dislocation they may also require tibial tubercle transfer.