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

The dislocation of the patella is an unpleasant pathological condition in which a knee cap is displaced in a person.

Structure of the joint

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 ligament apparatus, protecting them from damage.

Its balance is ensured by bundles of the quadriceps muscle of the thigh, its own ligament, and also by other muscles.

The patellar patch, as well as the bone itself, plays an important role in limb movement. These joint elements provide the quadriceps muscle with sufficient force to flex the leg. Any injury to this part of the knee is fraught with serious complications, as well as restriction of human mobility.

Types of pathology

The dislocation of the patella can be classified as follows:

1. Congenital. This type of pathology is extremely rare. The main cause of this condition is considered insufficient development of tissues, of which the joint was built.
2. Traumatic, or acquired. In this case, the damage results from a fall or direct impact. If the patellar bias occurs more than once a year and is periodic, then a 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 bone displacement:

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

And still it is possible to divide a pathology on degree of displacement of a bone:

1. Easy. In this case, the patient practically does not feel pain, and the trauma itself can be detected only when examined by a doctor, by accident.
2. Average. 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 complete restriction of leg mobility. Muscles of the thigh are tightened, but the person's health is deteriorating.

Causes of the disease

The dislocation of the patella can be provoked:

• Direct injury (side impact, sharp turn).
• Defect in the structure of the articulation.
• Too much muscle tension.
• Physiological features of the body.
• Inflammatory degenerative diseases of the knee.
• Operative intervention on the joint.
• Dysplasia of the condyles of the thigh.
• Falling from a height.

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

Symptomatology of pathology

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

1. In the injured area there is a strong and sharp pain.
2. The knee cap is deformed.
3. An obvious patellar shift in the side or up and down.
4. A person can not bend or unbend a knee, lean on his leg.
5. Unpleasant feelings are gradually amplified.
6. The appearance of edema in the affected area.
7. Redness of the skin.
8. Sensation of instability of the joint.
9. Increased temperature in the area of the affected joint.

If one or more of the symptoms presented are present, the doctor should be contacted immediately. Otherwise, the patient can expect serious complications. Also, you should not patch the patella yourself, because you can make it even worse.

Diagnostic Features

Naturally, the patient must undergo a thorough differential examination. The point is that it is necessary to distinguish the dislocation and fracture of the patella, and also to exclude other pathologies. Diagnosis involves the use of such methods:

• External examination of the patient, palpation of the injured knee, and fixation of complaints.
• Radiography. And it is necessary to make a comparative snapshot of both joints. X-rays are made in several projections.
• MRI. The procedure allows you to get the maximum clinical picture, which will give an opportunity 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 proved to be of little informative.

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

Conservative treatment of dislocation

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

Further actions of doctors are as follows:

1. The injured part of the leg should be anesthetized. In this case, an injection method is used, since it provides a quick effect.
2. Patellar should be carefully adjusted to avoid damage to the cartilage and not increase the risk of complications.
3. On the foot you need to impose a fixative bandage or gypsum. The duration of its application is 6 weeks.
4. Through gypsum, the joint should be heated with UHF.
5. After the bandage is removed, the specialist makes a control x-ray study.
6. Then follows the period of restoration of the functionality of the joint.

Operative intervention

If a patient has a patellar fracture, or if conservative therapy is ineffective, surgery is applied. The surgeon makes a puncture of the joint, removing the accumulated liquid inside it. After the intervention, the patient will have to undergo another course of recovery, the duration of which is at least 9 weeks.

There are such types of surgery:

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

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

The expediency and necessity of carrying out the surgical intervention is determined by the doctor.

Rehabilitation after trauma

The recovery process must be performed under the close supervision of the orthopedist. Rehabilitation includes the feasible load on the damaged joint, strengthening muscles, massage, as well as physiotherapy procedures.

The patient is selected individual complex of physical exercises, which will restore the amplitude of movements and knee functionality in full. Naturally, do not overload the articulation too much, especially in the postoperative period. For muscle training, flexion and extension exercises are used. The angle must 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 dislocate the patella did not occur, it is required to observe such preventive measures:

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

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

Another complication of the pathology is the dystrophy of ligaments and cartilaginous tissue. The patient has weakness in the muscles, which almost does not allow you to move your foot.

In 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, it is better to avoid those factors that can provoke a repetition of the displacement. Be healthy!