Patella dislocation (adults)

Introduction

Patella dislocations are not uncommon knee injuries, especially in younger people (< than 30 years). 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.

Exercise

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. It is helpful to place a rolled up towel below the ankle. 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, 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.

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.