Dislocation of the patella: causes, symptoms, treatment and rehabilitation

Dislocation of the patella is an unpleasant pathological condition in which a person has a displacement of the patella.

Joint structure

So, the presented joint is one of the most mobile and loaded in the human body. It includes an oval bone (patella), which covers the muscles and ligamentous apparatus, protecting them from damage.

Its balance is ensured by the ligaments of the quadriceps femoris, its own ligament, as well as other muscles.

The ligament of the patella, as well as the bone itself plays a large role in the movement of the limb. These articulation elements provide the quadriceps muscle with enough strength to bend the leg. Any injury to this part of the knee is fraught with serious complications, as well as a restriction of human mobility.

Types of pathology

Dislocation of the patella can be classified as follows:

1. Congenital. This type of pathology is extremely rare. The main reason for this condition is considered insufficient development of the tissues of which the joint is built.
2. Traumatic, or acquired. In this case, damage is caused by a fall or direct impact. If the displacement of the patella occurs more than 1 time per year and is periodic, then the dislocation in this case can be called habitual.

In addition, the pathology is acute and chronic. And you can also classify the dislocation in the direction of the bone displacement:

• Rotary. The patella moves around its axis.
• Side. It appears as a result of a fall on an unbent leg or an impact.
• Vertical. This type of injury is extremely rare. The bone here moves in a horizontal plane and enters the joint space.

And you can also divide the pathology according to the degree of bone displacement:

1. Easy. In this case, the patient practically does not feel pain, and the trauma itself can be detected only upon examination by a doctor, by accident.
2. Medium. Here the gait of the victim is already changing, he can often fall.
3. Heavy. It is characterized by very severe pain, as well as a complete restriction of leg mobility. The thigh muscles are very tight, and the person’s well-being is getting worse.

Causes of the disease

Dislocation of the patella can be triggered by:

• Direct injury (side impact, sharp bend).
• A defect in the structure of the joint.
• Too much muscle tension.
• The physiological characteristics of the body.
• Inflammatory degenerative diseases of the knee.
• Surgery on the joint.
• Dysplasia of the condyles of the thigh.
• Fall from a height.

In addition, the ligament of the patella can not perform its functions well enough. These causes of patellar dislocation are quite common. However, they can also be warned.

Symptoms of pathology

Before starting treatment, it is necessary to understand how the pathology manifests itself. So, if a person has a dislocation of the patella, the symptoms are as follows:

1. In the injured area, severe and sharp pain appears.
2. Deformation of the patella occurs.
3. Explicit displacement of the patella to the side or up and down.
4. A person cannot bend or unbend his knee, lean on his leg.
5. Unpleasant sensations gradually intensify.
6. The appearance of edema in the affected area.
7. Redness of the skin.
8. Sensation of joint instability.
9. An increase in temperature in the affected joint.

If one or more of the presented symptoms is observed, you should immediately consult a doctor. Otherwise, the victim may expect serious complications. Also, do not set the patella on your own, as you can make it worse.

Diagnostic Features

Naturally, the patient needs to undergo a thorough differential examination. The fact is that it is necessary to distinguish the dislocation and fracture of the patella, as well as exclude other pathologies. Diagnostics involves the use of such methods:

• External examination of the patient, palpation of the damaged knee, as well as fixation of complaints.
• Roentgenography. Moreover, it is necessary to make a comparative picture of both joints. X-ray is done in several projections.
• MRI The procedure allows you to get the maximum clinical picture, which will make it possible to prescribe effective therapy.
• Arthroscopy This procedure is both diagnostic and therapeutic at the same time. It is used for research if other methods have been uninformative.

Based on the information received, the traumatologist or orthopedist paints a treatment and rehabilitation scheme for the patient.

Conservative treatment for dislocation

Immediately after injury, cold should be applied to the damaged area. This will calm internal bleeding (if any), relieve swelling and reduce pain. Naturally, it is better to immobilize a limb and call a doctor or go to the emergency room.

Further actions of doctors are as follows:

1. The injured part of the leg should be anesthetized. In this case, the injection method of administration of the drug is used, since it provides a quick effect.
2. The patella should be carefully adjusted so as not to damage the cartilage and not increase the risk of complications.
3. A fixing bandage or plaster cast should be applied to the leg. The duration of its use is 6 weeks.
4. Using gypsum, the joint should be warmed with UHF.
5. After the bandage is removed, the specialist performs a control x-ray examination.
6. This is followed by a period of restoration of joint functionality.

Surgical intervention

If the patient has a fracture of the patella, or if conservative therapy is ineffective, surgery is used. The surgeon performs a puncture of the joint, removing the fluid accumulated inside it. After the intervention, the patient will have to take another recovery course, the duration of which is at least 9 weeks.

There are such types of surgical intervention:

1. Open plastic of the medial ligament.
2. Arthroscopy
3. Transposition of distal ligament attachment.

Early and correct operation can eliminate hemarthrosis, damaged parts of the cartilage, suture and fix the joint capsule. It should be noted that if the dislocation is accompanied by a rupture of the ligaments, then it is impossible to stitch them. To restore joint mobility, artificial or donor tissue is used.

The feasibility and need for surgery is determined by the doctor.

Post-injury rehabilitation

The recovery process should be under the close supervision of an orthopedist. Rehabilitation includes feasible loads on the damaged joint, strengthening muscles, massage, as well as physiotherapeutic procedures.

An individual set of physical exercises is selected for the patient, which will allow to restore the amplitude of movements and knee functionality in full. Naturally, you should not overload the joint too much, especially in the postoperative period. For muscle training exercises are used flexion and extension of the limb. In this case, the angle should not be large.

During rehabilitation of the knee joint, the patient can use special fixing bandages that will not allow the cup to move again.

Prevention of pathology and possible complications

To prevent dislocation of the patella, it is necessary to observe the following preventive measures:

• Every day you need to perform simple physical exercises that will help strengthen the muscles and ligaments that hold the patella.
• It is better to avoid sudden movements and heavy load on the joint.
• With a genetic predisposition or deformation of the joint, it is better to abandon dancing, skiing, jumping.

If a person is diagnosed with a dislocation of the patella, treatment must be performed without fail. Otherwise, complications are possible. For example, a patient begins to develop arthrosis of the knee joint. In addition, a dislocation may become habitual. That is, the patella will shift even from minor physical exertion. In this case, the therapy is somewhat complicated.

Another complication of the pathology is the degeneration of ligaments and cartilage. The patient develops muscle weakness, which practically does not allow him to move his leg.

In the case of proper treatment and effective rehabilitation, the prognosis of the pathology is favorable. That is, the functionality of the joint is fully restored. However, those factors that can provoke a repetition of displacement, it is better to avoid. Be healthy!