PATELLA LUXATION: HOW DOES IT OCCUR,

by Alex Musk

The Topic Of This Post

  • What is the patella and what is it for
  • Patellar luxation: who is affected and how does it happen?
  • Causes of Patellar Dislocation
  • Patella luxation symptoms and diagnosis
  • Recommended treatments after patella dislocation
  • Acute phase
  • When is surgery needed?
  • Recovery after patella dislocation

Patellar luxation is a type of rather serious injury involving the knee and in particular the area of the patella, the bone which is located in the front of the joint. If a dislocation occurs, the patella moves (luxates) laterally and, in moving, can damage the ligaments that surround it and the cartilage that surrounds it. Today we go deeper into this problem, to understand how it occurs, how to intervene immediately, and how recovery takes place.

WHAT IS THE PATELLA AND WHAT IS IT FOR

The patella, also called the patella, is a bone that belongs to the knee joint, and is fundamental for the extension of the leg: it is located in the front, it is protected by cartilage and ligaments, and its shape resembles that of a triangle slightly rounded inverted.

It is a connection point of primary importance between bones, tendons, and muscles: the upper part acts as a coupling for the thigh muscle (quadriceps), while the lower edge is the insertion site of the patellar tendon.

Its functions are different. It:

  • it allows the extension of the leg, playing a fundamental role for walking;
  • protects the internal structure of the knee, in particular the anterior and posterior cruciate ligaments, which are very delicate;
  • acts as a lever and improves the performance of the quadriceps.

So how does patella dislocation happen and what does an injury involve in such an important point of the human body?

AndreyPopov/istock.com

PATELLAR LUXATION: WHO IS AFFECTED AND HOW DOES IT HAPPEN?

First of all, it is important to distinguish the dislocation of the patella from that of the knee: in the first case, the patellofemoral joint is affected, in the second the femorotibial joint, which connects the upper part of the leg (femur) with the tibia.

Dislocation of the patella occurs when it moves to the side, out of its seat: statistically, episodes of this type mainly involve young sportsmen, from adolescence up to about 25 years, mostly women.

This probably happens because the body is in a phase of development and the muscular, bone, and ligament systems are growing and evolving: during efforts and training some points – such as the patella, are subject to stressful impacts and movements that can lead to dislocation.

CAUSES OF PATELLAR DISLOCATION

As mentioned, patella dislocation occurs frequently during sports and the causes of this injury are mainly two:

  • direct trauma, with a bump or strong impact in the knee area;
  • sudden contraction of the quadriceps of the femur when the knee is semi-flexed and the leg is turned slightly outwards.

These cases then become particularly dangerous if the subject has a predisposition to the hyper lax patella, a condition in which, for anatomical reasons or previous physical problems, the ligaments are unable to keep the patella on axis, which therefore risks moving more easily.

PATELLA LUXATION SYMPTOMS AND DIAGNOSIS

At the time of dislocation, the pain is very acute: in a few minutes the knee appears swollen and swollen, and often blood spills also occur.

It is therefore impossible to continue with the activity that was taking place, and even walking becomes very difficult because it is not possible to carry out the usual actions of bending and stretching the knee.

Sometimes the patella may come out and come back into place: in these cases, the pain is still very strong, but it is possible to move the joint and load the weight on the leg.

The diagnosis of patellar luxation is made with an x-ray, which can also be associated with a CT scan and an MRI to investigate any involvement of other elements of the knee, for example, ruptures of the meniscus, ligaments, or bone fractures that could deposit splinters in the joint.

RECOMMENDED TREATMENTS AFTER PATELLA DISLOCATION

In case of dislocation, prompt intervention and correct treatment in the recovery period are very important. Let’s see together how to deal with these phases.

ACUTE PHASE

The acute phase, which can vary from a few hours to days, indicates the moment immediately following the accident and the period in which the pain is still severe and the injured person cannot move:

  • the first action that a physiotherapist, a doctor, or a specialized operator performs is the so-called reduction, or the re-insertion of the patella in its seat; following this manipulation, the pain decreases and the injured person will be able to move the leg again, albeit with difficulty.
  • At this point it is recommended to apply ice, carrying out compressions on the knee.
  • To immobilize the joint, an elastic bandage, splint or brace can be applied.
  • It may be helpful to take anti-inflammatory drugs under medical supervision in the first few days after the injury to relieve pain.

WHEN IS SURGERY NEEDED?

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During the acute phase, two conditions may emerge in which surgery is required:

  • presence of a bone fracture
  • injury to joint cartilage or ligaments.

Depending on the severity of the fracture and the portion of cartilage and ligaments affected, a decision will be made whether to proceed through arthroscopic surgery (which involves the insertion of a small optical fiber probe through which the joint is repaired) or through surgery with the incision.

RECOVERY AFTER PATELLA DISLOCATION

The rehabilitation period will be different if the injured person has undergone surgery or if knee immobilization was sufficient.

If the patella has been immobilized, it will be necessary not to bend the knee for about two weeks: the injured person must always walk with crutches, wearing the brace. In the subsequent rehabilitation period, joint movement with bending up to 60 degrees (in the third week) and up to 90 degrees (in the fourth week) is allowed. After that, we will move on to strengthening the quadriceps, to then recover complete mobility of the leg. Before resuming sports, it is recommended to wait 8 weeks.

Following the surgery, the hospital stay is 24 hours. Right from the start, the injured person must comply with the rehabilitation protocol, similar to the one mentioned above. However, it will be necessary to wait 5 months after the operation before being able to practice sport again.

 

In the case of patellar dislocation, it will then be very important to undergo frequent specialist checks, to monitor the recovery of mobility. Since it is a type of injury that mainly affects sportsmen, it may be useful to consult a physiotherapist, who can follow the patient during the rehabilitation period and also in the moment of resuming activity. In this case, you can use a medicare insurance policy, such as, which covers the costs of physiotherapy and rehabilitation treatments, and also reduces waiting times to access the necessary treatments.

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