What is Patellar Subluxation?
Kneecap or patella is small triangular bone located in the front of knee. When knee bends or straightens, the kneecap moves up and down smoothly in the groove due articular cartilage. Patellar subluxation is caused due to forced leg straightening or other factors, when kneecap will subluxates temporarily from its place in the groove partially, which is located at the end of thigh bone.
When patella completely dislocated from the groove, it is called kneecap dislocation and when it is partially dislocated, it is called as patellar subluxation. This condition is also referred to as patellar instability or unstable kneecap. It is mild dislocation and the tendons, muscles and ligaments associated with patella will sometime gets damaged, which will result in instability in the knee.
What are the Symptoms of Patellar Subluxation?
The symptoms usually includes
- Severe pain in front of the knee.
- Kneecap will be dislocated.
- Audible cracking or popping sound can be heard.
- Difficulty in bending or straightening leg.
- Knee giving away sensation.
- Knee instability.
- Stiffness in knee.
- Difficulty in putting weight on knee or while walking.
- Grinding sensation can be felt.
What are the Causes of Patellar Subluxation?
There are several causes of knee subluxation and some of them are:
- Excessive traumatic sideway movements
- Severe blow to side of knee.
- Broad pelvis.
- Forceful knee straightening.
- Shallow groove.
- Abnormalities in gait.
- Abnormality in knee structure i.e patella or femure.
- Tight ligaments or tendons.
- Loose ligaments or tendons.
- Twisting injuries.
- Can be due to Illiotibial band syndrome or chondromalacia.
- Mal-alignment of patella.
- Undeveloped inner thigh muscles
- Overdeveloped inner thigh muscles.
Diagnosis of Patellar Subluxation:
Doctors general ask the cause and symptoms of patellar dislocation in detailed manner with the patient. He or she will even ask comprehensive medical history i.e. enquiring any previous knee injury. Then they will conduct physical examination i.e. examining the knee while bending or straightening the leg in order to track, align and even stabilize the patella.
Since patellar subluxation always associated with other knee conditions or injuries, doctors often advise X-ray, MRI and CT scan, which assist in accurate diagnosis of patellar subluxation and rule out any further complications.
Treatment of Patellar Subluxation:
Since the treatment for patellar subluxation depends on the severity of the dislocation, some of the most common treatment methods are:
- PRICE formula: The acronym stands for protect, rest, ice, compress and elevate.
- Protect: Protect and safeguard your knee from further injuries and avoid any aggravating activity that could worsen simple dislocation to severe problem.
- Rest: Rest is critical component of any treatment, the same applies to the case of patellar subluxation.
- Ice: Apply ice pack or gel pack to the point for injury several times a day for a period of 15-20 minutes. Put the ice wrapped in towel because applying directly will damage the soft tissues.
- Compress: Elastic bandages are the best way of compressing the injured area so that swelling and pain will get reduced.
- Elevate: Raise your leg above the level of heart. You can use pillows below you leg to elevate.
- Nonsteroidal anti-inflammatory medicines (NSAIDs): Ibuprofen, naproxen, aspirin or acetaminophens will help reduce swelling and pain. But, it is important that you consult your doctor before diagnosing any medications because excess dose may result in stomach bleeding and other complications.
- Knee Brace: In order to keep patella in appropriate position or in its groove, it is important to wear a knee brace. There are specific knee braces that specially designed for treatment of patellar dislocation. Ask your doctor for appropriate knee brace.
- Taping and Splinting: Both are beneficial in keeping patella in its groove. However, they are short term solutions and provide symptomatic relief.
- Physical Therapy: Physical therapy is extremely important component of treatment. It greatly improves the mobility and motion of the knee. It even prevent further injuries and help you to recover from disability Consult your physical therapist for performing effective exercises that could lend a hand in recovering successfully from patellar subluxation. Pelvic stabilization exercises like hip abductors as well as hip flexors are extremely effective in strengthening and stabilizing kneecap. Quadriceps stretches and Iliotibial band stretches are also beneficial. Doctors often recommend physical therapy for first time patellar subluxation. Some of the other patellar subluxation exercises are:
- Hamstring stretch on wall
- Standing calf stretch
- Quadriceps isometrics
- Straight leg raises
- Prone hip extension
- Wall squat with ball
- Knee stabilization
- Resisted knee extension
- Knee Immobilizers: They are used to provide support to the knee during the treatment. They are also quite effective in preventing unwanted movements in the knee that could further complicate the injury.
- Comfortable Footwear: Good footwear that should be both comfortable and better for contributing to the gait cycle is extremely important in the treatment of patellar subluxation because it will reduce the force and pressure on the kneecap.
- Surgery: If the patient complains of persistent pain or the subluxation is recurring, then doctors may advise surgery called as lateral release wherein tight lateral ligaments are loosed to help patella stays in its groove. Sometimes, the mal-alignment will also causes patella to move out of the groove. This is also fixed with the above-said surgery.
Recovery Period for Patellar Subluxation:
The recovery really depends on the severity of pain and type of treatment. So, it’s really hard to provide exact recovery period. However, it takes nearly one month for complete recovery with physical therapy.
Conclusion – Patellar Subluxation:
The outlook is good because you can resume your daily activities in a period of month or so. However, if sporting activities is resumed while the patellar subluxation is still sore, then you may again dislocated your patella. Strengthening the surrounding muscles and avoiding aggravating activities will help prevent the patellar subluxation to recur.