In the article, we will consider why the patella flies.
The patella, or patella, is a round-shaped bone that protects the joint from various injuries. She is held by strong connective tissue formations - ligaments that create a stable position for her. When the kneecap flies out, ligament rupture or sprain may occur, and during the injury a person feels acute pain. After it can independently fall into place, however, in most cases, it again pops up with further bruises or falls. Such an injury is characterized by severe pain, it can appear with sharp and incorrect turns of the leg, requiring immediate medical attention.
Causes
When the patella flies out, there are various causes for such an injury. Why is this happening? The weight of the patient affects the appearance of the injury: if it is too large, this is an additional burden on the joint, which creates an additional risk.
The main reasons are: violation of the articular surface; improper immobilization; primary dislocation, which violates tissue integrity; ignoring the rest mode during recovery; untimely therapy or advanced disease.
Provocative factors
Among other things, if the patella flies out, such a problem may appear due to various factors.
These include: high articular mobility; muscle imbalance; atrophy of the femoral muscle; high standing of the patella; knee deformity; ligament weakness; increased loads; curvature of the legs; age. When a person has weak muscles, they cannot hold a calyx in a normal position. The same applies to ligaments. Excessive knee mobility also often causes problems. The condition of the calyx itself, muscles and bones is also affected by age. Cartilages and joints wear out over time, various disorders appear - osteochondrosis, osteoporosis. All this increases the likelihood of a problem. With strong physical exertion, the cup usually does not pop up immediately - after prolonged exposure and lack of rest for the limbs.
Symptoms
By what signs can it be determined that the patella is flying out? Most often, acute pain immediately appears, which intensifies during movement. Mostly the joint is slightly bent, its volume is increased, there is a feeling of the beginning of its loss. Strongly swollen knee. What other symptoms indicate a problem with the patella? The main signs that the patella flew out and stood back: hemorrhage; edema; fossa from below or above the knee; Feeling of mowing when walking. If the knee pops up, the pain gives up to the thigh, and the knee itself also hurts. There may be bruising. The leg does not move at all, the knee swells quickly.
Degree of violation
Three degrees of violation are distinguished:
- The first is not characterized by constant pain, a very mobile cup, the patella is able to return to its correct position.
- In the second degree, a significant deformation occurs, severe pain is felt.
- The third is characterized by severe and severe pain, increased deformity and limited movement.
Externally, you can see changes in the shape of the knee, as the patella moved. But this is far from always noticeable, but only with the second and third degrees of pathology.
So, the patella flies out. What to do?
Diagnostics
The specialist examines the limbs: both sick and healthy. This is important in order to accurately diagnose. It is also necessary to conduct magnetic resonance imaging and ultrasound diagnostics.
The doctor prescribes an x-ray of the legs. Due to this, additional injuries (fractures, cracks) are excluded.
An interesting note: in the presence of partial ruptures, the patella moves slightly downward, with full ruptures, it moves up and up. In addition to such diagnostic methods, the specialist must pay attention to other circumstances: age and body weight of the patient, articular mobility.
Naturally, the doctor should receive information about the following factors: impaired posture; flat feet; localization of pain; location of the calyx; asymmetric muscle strength. When all the information is received, treatment is prescribed.
If a person's kneecap flew out and stood back, and this happens periodically, the symptom needs a more thorough diagnosis. The joint is examined using MRI and ultrasound, such methods will allow you to visualize the condition of the ligaments, soft tissues, tendons and muscles. Based on the results of the study, treatment is prescribed.
Treatment
What actions to take? It often happens that the patella flew out and fell into place, or the patient straightens the knee on his own. But this does not eliminate the cause of the pathology. In this case, you can not delay with going to the doctor to avoid increased destabilization, deformation and destruction of the knee. Only a specialist determines the tactics of treatment for an ejected knee joint, it depends on the degree of damage to the ligaments, menisci, the presence of marginal fractures in the cup, the condition of the cartilage tissue, and the integrity of the surfaces of the joints.
When the patella flies out, treatment of such a disorder lasts on average about six months. If there is no serious damage, then in such cases conservative methods are usually used that can help quite well.
Conservative methods
When choosing a treatment regimen, they primarily resort to conservative methods.
To reduce pain in the acute state, you need to apply ice to the joint, this can be done as first aid if the injury is acute.
It is necessary to immediately contact a specialist to clarify the degree and cause of the violation, especially important is the elimination of rupture of ligaments and other defects in the integrity of tissues near the joints. This determines further therapy.
First, you first need to completely, then partially reduce the usual load on the limb. This is achieved by wearing orthoses, the use of elastic bandages, bandages or orthopedic devices.
If a person has hemarthrosis, articular puncture is done with further aspiration.
The inflammatory process will help remove anti-inflammatory non-steroidal drugs - “Ibuprofen”, “Voltaren”.
Severe pain syndrome can be stopped by means of analgesics.
As soon as the condition improves at least a little, you need to be like physiotherapy and massage. A set of physiotherapy exercises is required (primarily static exercises), due to the restoration of muscle balance. This mainly applies to extensor muscles.
When the knee extends, physical activity is mandatory. To reduce re-dislocation, you need to train your muscles.
Surgical intervention
In the absence of the effect of conservative methods or a too pronounced degree of damage to the joints near tissues or joint structures, if the process is running, a specialist can advise you to be treated using surgical methods.
There are currently many ways to do this for patella problems. However, treatment using most of the methods quite often causes relapses and does not exclude the occurrence of secondary intraarticular changes.
If the reasons due to which the patella is constantly shifting are because the external ligament is too tight compared to the internal, the treatment consists in dissecting the ligament using an arthroscope. Such an intervention is well tolerated by patients, does not need a long recovery, and is minimally invasive. If the calyx of the knee joint has flown out and a lateral displacement has occurred, a lateral incision is made. In a number of institutions, a thermocauter is used to prevent bleeding in the joint with the formation of hemarthrosis.
Prevention and recommendations of doctors
To prevent problems due to which the patella flies out, you should immediately consult a doctor with an acute dislocation and take measures. Experts recommend doing this even when the patella itself has returned to its place. During treatment, you should listen to the doctor in everything and not violate the limited loads. After stopping the acute condition, it is very important to continue to train and exercise, since the knee can be stabilized only with normal muscle tone of the lower leg and thigh. In this case, you need to gradually increase the load, after discussing this with your doctor. He will recommend the most optimal rehabilitation measures and special exercises for each patient.