Patella dislocation

Introduction

Patella dislocations are not uncommon knee injuries, especially in children and young people. It is normal to have pain and stiffness afterwards. 

What are the symptoms?

These vary from person to person. Once the knee cap (patella) has been relocated people may experience:

• Swelling
• Pain
• Loss of movement and strength around the knee
• Reduced ability to bear weight through the knee

What are the causes?

The injury is usually caused when twisting the knee. It could, however, result from a direct blow during sporting activity or during a fall. It can be the result of a combination of muscle function, ligament tightness and the bony alignment of the knee.

Restoring normal movement and walking as soon as possible is crucial to avoid post-injury stiffness and weakness. The more you move and use your leg, the quicker it will heal. Regular use of ice and painkillers are important to manage swelling and discomfort. If you are ‘too sore to move,’ this will slow your recovery. 

If you have been given a knee brace or elbow crutches this is for support and reassurance. The knee brace can be removed unless otherwise advised, once you feel more comfortable in moving your knee. This can be done in short spells and whilst doing the exercises.

Moving your knee the first few times without the brace can be uncomfortable, but ‘little and often’ is helpful.

This is particularly true for anxious younger children who may need extra support and encouragement.

You should aim to have stopped using the brace after 7 to 10 days. It should NOT be kept on for longer than 2 weeks.

You do NOT need to be seen by a healthcare professional first to remove the brace.

Putting as much weight as possible on your leg over the next few days will also aid your recovery. If you have been given crutches, gradually decrease their use of them over the next few days.

The simple exercises below will help you get your movement back.

1. Lying on your back. Bend and straighten your leg. Repeat 10 to 15 repetitions, rest and repeat another 3 times. Repeat this 3 times per day.

2. Sit or lie with affected leg straight. Bend your ankle and push your knee down firmly against the bed. Hold for approximately 5 seconds, and slowly relax.

3. Lying on your back, bend one leg, put your foot on the bed, and put a cushion under the affected knee. Exercise your affected straight leg by pulling your foot and toes, tightening your thigh muscle and straightening the knee (kneecap on the cushion). Hold approximately 5 seconds, and slowly relax.

4. Lying on your back with the affected leg straight and the other leg bent. Exercise your affected straight leg by pulling the toes up, straightening the knee and lifting the leg 10 to 20cm off the bed. Hold for approximately 5 seconds, slowly relax. Repeat with both legs.

5. Sit on a chair, pull your toes up, tighten your thigh muscle and straighten your knee. Hold for approximately 5 seconds, and slowly relax your leg.

If you have been discharged with a brace and crutches, you will also probably be referred for Physiotherapy. Following the advice before attending the physiotherapy appointment is important and will speed up your recovery.

Please remember:

Most soft tissue injuries can take 4 to 6 weeks to resolve. You should gradually return to normal activities over this time. Once you have full movement, strength and no swelling, you should feel confident about returning to full activities.

If there is no improvement in your condition after 4 to 6 weeks, you should seek the advice of a healthcare professional. If your pain does not settle, you may be referred for further assessment and treatment as appropriate.