What happens when your knee feels like it popped out and back in. How is patellar instability diagnosed and treated. Can knee dislocation be prevented and what are the long-term implications.

What Is Patellar Instability and Why Does It Occur?

Patellar instability is a condition where the kneecap (patella) moves out of its normal position within the trochlear groove. This groove is designed to keep the kneecap stable and prevent it from sliding. When instability occurs, it can lead to partial or complete dislocation of the kneecap.

There are two main types of patellar instability:

• Acute: Typically occurs during sports activities, especially in young athletes aged 13-20
• Chronic: Recurring instability due to underlying anatomical issues or repeated injuries

Teenage females are at the highest risk due to anatomical factors. Sports like football, basketball, and volleyball have the highest incidence rates of acute patellar instability.

The Mechanics of Knee “Popping”: Subluxation vs. Dislocation

When a knee “pops” out of place, it can result in either subluxation or dislocation:

• Subluxation: A partial dislocation where the kneecap slightly shifts out of the groove and then returns to its original position
• Dislocation: The kneecap moves entirely out of the groove and remains displaced

In a normally functioning knee, the kneecap moves up and down within the trochlear groove as the leg bends and straightens. Patellar instability occurs when the kneecap doesn’t track properly along this groove.

Common Causes of Kneecap Dislocation

Kneecap dislocations can occur due to various factors:

• Non-contact twisting injuries when the knee is almost fully extended
• Direct blows to the kneecap during sports activities
• Falls or accidents that impact the knee

Recognizing the Symptoms of a Dislocated Knee

If you’ve experienced a knee dislocation, you may notice several symptoms:

• Severe pain in the affected area
• Noticeable swelling around the knee
• Visible deformity of the knee joint
• Reduced range of motion
• Tenderness when touching the area
• “Popping” sounds during knee movement or while climbing stairs

Is immediate medical attention necessary for a dislocated knee? Yes, even if the kneecap appears to have relocated on its own, it’s crucial to seek professional evaluation. A specialist can assess potential damage to surrounding muscles, ligaments, nerves, and blood vessels.

Diagnostic Approaches for Patellar Instability

Accurate diagnosis of patellar instability involves several steps:

1. Review of medical history
2. Physical examination, including an apprehension test
3. Imaging tests, such as X-rays, to rule out fractures and assess the position of the kneecap

Why is a comprehensive diagnosis important? A thorough evaluation helps determine the extent of the injury and guides the most appropriate treatment plan, whether conservative or surgical.

Treatment Options: From Conservative Management to Surgery

The treatment for patellar instability varies depending on the severity and frequency of the condition:

Non-Surgical Interventions

• Swelling reduction techniques
• Bracing to immobilize the knee joint
• Use of crutches to assist with weight-bearing
• Physical therapy to strengthen muscles and improve range of motion

Surgical Options

For chronic instability or complete kneecap dislocations, arthroscopic surgery may be recommended. This minimally invasive procedure can help stabilize the kneecap and repair damaged tissues.

How effective is physical therapy in treating patellar instability? Physical therapy plays a crucial role in recovery by strengthening the muscles that hold the kneecap in place and improving overall knee function.

Preventing Recurrence: Strategies for Long-Term Knee Health

Preventing patellar dislocation from recurring involves several strategies:

• Activity modification to avoid high-risk movements
• Regular stretching exercises
• Strengthening quadriceps muscles
• Using appropriate bracing during activities
• Wearing custom orthotics for better foot and leg alignment
• Maintaining a healthy body weight to reduce stress on the knees

Can lifestyle changes significantly reduce the risk of patellar instability? Yes, adopting a proactive approach to knee health through exercise, proper footwear, and weight management can greatly decrease the likelihood of recurrent dislocations.

When to Seek Professional Help for Knee Issues

It’s essential to consult a healthcare professional if you experience any of the following:

• Severe knee pain following an injury
• Visible swelling or bruising around the knee
• Inability to bear weight on the affected leg
• Recurring sensation of the knee “giving way” or instability

Early intervention can prevent further damage and improve long-term outcomes. Specialized orthopedic centers often offer comprehensive care for knee-related issues, including patellar instability.

Long-Term Outlook and Management of Patellar Instability

The long-term prognosis for individuals with patellar instability depends on several factors:

• Severity of the initial injury
• Frequency of dislocations
• Adherence to treatment and rehabilitation plans
• Underlying anatomical factors

With proper management and preventive measures, many people can return to their normal activities and sports. However, some may need to make long-term adjustments to their lifestyle or sporting activities to maintain knee health.

Ongoing Care and Monitoring

Regular follow-ups with an orthopedic specialist are important for:

• Assessing the progress of rehabilitation
• Adjusting treatment plans as needed
• Monitoring for signs of arthritis or other long-term complications
• Providing guidance on safe return to sports or high-impact activities

How often should individuals with a history of patellar instability have their knees evaluated? It’s generally recommended to have annual check-ups, but the frequency may vary based on individual circumstances and the advice of your healthcare provider.

Advances in Patellar Instability Treatment and Research

The field of orthopedics continues to evolve, bringing new hope for those suffering from patellar instability:

Innovative Surgical Techniques

• Minimally invasive procedures with faster recovery times
• Advanced imaging-guided surgeries for more precise interventions
• Customized 3D-printed implants for complex cases

Emerging Non-Surgical Treatments

• Platelet-rich plasma (PRP) therapy to promote healing
• Stem cell treatments for tissue regeneration
• Advanced bracing technologies for better support and prevention

What role does genetic research play in understanding patellar instability? Ongoing genetic studies are helping to identify predisposing factors for knee instability, potentially leading to more personalized prevention and treatment strategies in the future.

Living with Patellar Instability: Practical Tips and Lifestyle Adjustments

Managing patellar instability often requires some lifestyle modifications:

Exercise and Activity Recommendations

• Low-impact exercises like swimming or cycling to maintain fitness
• Targeted strength training for knee stabilization
• Yoga or Pilates for improved flexibility and balance

Daily Life Adaptations

• Using supportive footwear in everyday activities
• Modifying home and work environments to reduce knee stress
• Learning proper body mechanics for lifting and carrying objects

How can individuals with patellar instability safely participate in sports? With proper rehabilitation and guidance from sports medicine professionals, many can return to sports with modified techniques or protective equipment. However, high-risk activities may need to be avoided or approached with caution.

The Psychological Impact of Knee Instability and Coping Strategies

Dealing with patellar instability can have psychological effects:

• Fear of re-injury leading to activity avoidance
• Frustration with physical limitations
• Anxiety about long-term knee health

Coping strategies to address these challenges include:

• Seeking support from mental health professionals specializing in sports psychology
• Joining support groups for individuals with similar conditions
• Setting realistic goals and celebrating small victories in recovery
• Practicing mindfulness and stress-reduction techniques

Can cognitive-behavioral therapy (CBT) help in managing the psychological aspects of patellar instability? Yes, CBT can be an effective tool in addressing anxiety and fear associated with knee instability, helping individuals develop a more positive outlook and approach to their recovery.

Understanding patellar instability and its implications is crucial for effective management and prevention of recurrent episodes. By combining medical treatment with lifestyle adjustments and proper self-care, individuals can significantly improve their knee health and overall quality of life. Regular consultation with healthcare providers and staying informed about the latest advancements in knee care are key to long-term success in managing this condition.

Why My Knee Popped Out Of Place, Then Right Back In Again

What Is Patellar Instability?

Patellar instability is a condition in which your kneecap slides or moves out of its normal position within your trochlear groove, which is the groove that your kneecap sits on. This groove helps to stabilize your kneecap and keep it from sliding.

However, if you have patellar instability, the movement will result in an unstable kneecap and can even lead to a dislocated kneecap. The instability of your patellar may be classified as acute or chronic, depending on how frequently it occurs.

Acute instances generally occur in sports, specifically football, basketball, and volleyball. Young athletes whose ages range from 13-20 have the highest incidence rates. Additionally, due to anatomic issues, teenage females are at the highest risk of experiencing instability.

What Happens When My Knee “Pops” Out of Place?

You may wonder what happens when your knee “pops” out of place. Two things can happen. When your knee “pops” out of place, your patella may be “subluxated” or “dislocated,” depending on the degree of your patella instability.

A subluxation is a partial knee dislocation and occurs when your kneecap slightly shifts out of the groove and then “pops” back into place. A patella dislocation occurs if your patella moves entirely out of the groove and stays in that position.

Generally, when you bend or straighten your leg, your kneecap will move up and down in your trochlea groove. When it comes to patellar instability, your kneecap does not track the groove properly.

What Causes a Kneecap Dislocation to Happen?

The most common cause of a kneecap dislocation is a non-contact twisting injury when the knee joint is almost fully extended. Additionally, a direct blow to the kneecap while playing sports, a fall, or another form of accident can cause a partial or complete dislocation.

Dislocated Knee Symptoms

If you have a dislocated knee, you may experience the following:

• Severe pain
• Swelling
• Visible deformity
• Decreased range of motion (ROM)
• Tenderness in the area
• “Popping” sounds when you bend your knee or climb stairs

How Can a Dislocated Knee Be Diagnosed?

To ensure that an accurate diagnosis is made, your specialist will first review your medical history. They will also perform an apprehension test to assess your injury. Imaging tests, such as an X-ray, may also be ordered to provide your specialist with a diagnostic view to ensure that your patella has not been fractured.

It is important to note that even if your knee cap moves back into place on its own, you should still seek the assistance of a specialist so that they can accurately provide a diagnosis and treatment if needed. They can also verify that the surrounding muscles, ligaments, nerves, and blood vessels have not been injured.

Treatment Options for a Dislocated Knee

Because each circumstance and injury will vary, your orthopedic surgeon will determine whether non-surgical or surgical intervention is the best treatment for your knee pain.

The initial management of your injury may include swelling reduction, bracing to immobilize your knee joint, and possibly using crutches to assist in weight-bearing so that your knee will not buckle.

Additionally, physical therapy can also be beneficial to your recovery because it strengthens the muscles that hold your kneecap in place. During your physical therapy sessions, a physical therapist will also assist you in improving your range of motion.

If you have chronic instability or a complete kneecap dislocation, your specialist may recommend an arthroscopic procedure.

How Can I Prevent Patellar Dislocation From Reoccurring?

Naturally, you may wonder how to prevent patellar dislocation from reoccurring. Below you will find some helpful tips to guide you in preventing this from becoming a recurring event.

Helpful Strategies to Decrease the Recurrence of Knee Dislocation:

• Modifying your activities
• Stretching
• Quad-strengthening to keep your thigh muscles strong
• Bracing
• Using custom orthotics
• Maintaining a healthy weight

A dislocated knee, whether partial or complete, can be extremely painful. Schedule an appointment with one of our board-certified specialists at OrthoNeuro today to get relief from your knee injuries!

For your convenience, we have many offices located throughout Columbus, OH. Let us provide you with the relief you deserve!

Dislocated kneecap – NHS

A dislocated kneecap is where your kneecap (patella) moves out of place. It is usually caused by an injury to the knee. Get medical advice as soon as possible if you think you have a dislocated kneecap.

Urgent advice: Get help from NHS 111 if:

You’ve injured your knee and:

• it’s very painful
• it’s swollen or bruised
• you cannot stand up or move your knee
• you think your kneecap dislocated and then moved back into place

You can call 111 or get help from 111 online.

Immediate action required: Go to A&E if:

You’ve injured your knee and:

• your knee has changed shape
• it becomes very swollen very quickly
• you felt a pop or snap in your knee
• you can see bone sticking out of your skin
• it’s bleeding heavily

Call 999 if you’re unable to get to A&E.

While you are waiting for medical help

If you think you have dislocated your kneecap, there are some things you can do while waiting for treatment:

Don’t

• do not raise the affected knee

• do not try to stand or walk on the affected leg

• do not try to put the kneecap back into place yourself

Treatment for a dislocated kneecap

A dislocated kneecap often moves back into place by itself.

Even if it does, you will still need to get it checked by a doctor. You will usually need X-rays or an MRI scan.

If your kneecap does not go back into place by itself, a doctor may have to move it back. You will be given a local anaesthetic and may be offered a sedative so you do not feel any pain.

Surgery may be needed if you have badly damaged your knee. Some people may also need surgery to stop the knee from dislocating again.

After treatment, you’ll need to go to follow-up appointments to check your knee is healing properly.

Recovering from a dislocated kneecap

It can take 6 to 8 weeks to fully recover from a dislocated kneecap, but you will usually be able to walk using the affected knee within a few days.

You may be given a knee support to wear for 2 weeks to help it heal. If walking is painful, using a crutch may help.

Your doctor or a physiotherapist will show you knee exercises that you should do regularly to help speed up your recovery.

Things you can do to help your recovery

There are some things you can do to help with the recovery of a dislocated kneecap.

Do

• take painkillers like paracetamol or ibuprofen to help with pain

• keep your knee and lower leg slightly raised and supported when resting to reduce swelling

• do knee exercises throughout the day to stop your knee getting stiff

• stay as active as you can

Page last reviewed: 25 January 2023
Next review due: 25 January 2026

Habitual dislocation of the patella treatment in Zaporozhye clinic of orthopedics

By itself, dislocation of the patella occurs rarely, but with congenital anomalies of the knee joint or as a result of other traumatic injuries of the knee patellar dislocations occupy the second most common place among injuries of the knee joint. What does the prefix “usual” mean? She talks about the periodic recurrence of such trauma.

Patella dislocation causes

In order for the patella to displace, which we often call the patella, an enormous load on the leg is necessary. Therefore, most often the cause of this injury is excessively active sports and related falls on the knees, lateral blows to the knee (medial and lateral subluxation of the patella), sharp extension of the knee joint

When such an injury occurs, they speak of an acute condition. If after a while the patella moves again, this is a habitual dislocation of the knee joint. Often it occurs after the reduction of acute displacement of the patella.

Symptoms and signs

Acute trauma to the patella develops characteristic symptoms. The patient feels a sharp severe pain, the patella is visually displaced, swelling of the joint develops. Usually the leg is very painful and difficult to move – bend or straighten, so you should immediately consult a doctor.

Habitual dislocation of the knee causes less pronounced symptoms. The most common are pain in the knee joint and a feeling of instability in the knee (the knee seems to be unstable and is not fixed when moving).

Diagnosis of a dislocated patella

If symptoms occur, you should immediately contact an orthopedic traumatologist for a diagnosis. The fact is that similar manifestations can also talk about other problems with the knee, for example, a fracture of the patella. Therefore, after a full-time examination, a specialist can prescribe:

• radiography of the knee joint in several projections
• MRI of the knee is the most informative diagnostic method that will show, among other things, the condition of the ligaments and treat at the same time.

Dislocation of the patella and its consequences

Injury to the patella is a serious injury that should not be taken lightly. Without timely access to a specialist and accurately selected treatment, it can provoke other problems with the knee joint. For example, dislocation of the patella, even over time, often significantly limits activity: there is constant discomfort and a feeling of instability in the joint. Also, dislocations can be repeated periodically – in this case, they talk about the habitual dislocation of the patella, when even with minor physical exertion, the patella is displaced. Chronic damage to the patella will eventually burn to cause arthrosis (that is, destruction of the joint).

Is surgery necessary for a dislocated kneecap?

Primary patella dislocation is usually treated conservatively. If there is a habitual dislocation of the patella, more serious treatment is needed. However, for repeated dislocations, we recommend surgical treatment – using arthroscopic techniques.

Treatment of patellar dislocation in our clinic

The recommendation of our specialists is to perform knee surgery in case of habitual patellar dislocation. In our clinic, preference is given to low-traumatic arthroscopic methods of treatment (the operation is performed through several punctures). Thus, an orthopedic traumatologist performs manipulations inside the joint as accurately and at the same time sparingly: aligns and fixes the patella, sanitizes the articular cavity, and, if necessary, removes hematomas. Such treatment makes it possible to stop recurring dislocations and to prevent arthrosis.

Rehabilitation after dislocation of the patella

Since arthroscopy is a gentle surgical technique, the rehabilitation period does not last long. An experienced rehabilitation specialist monitors the recovery after treatment in our clinic. It is worth noting that the specialist starts working with patients the very next day after the operation in order to maintain the joint in good shape. A specialist for each develops an individual rehabilitation plan, exercise therapy and physiotherapy for a speedy recovery.

Hyaluronic acid injections or PRP therapy may also be given to improve joint function. These procedures help to improve the nutrition of the joint and speed up healing.

Treatment Habitual dislocation of the patella – Orthopedics Ruslana Sergienko

The patella, or patella, is a small oval bone located above the condyle of the femur in front and above the knee.

Dislocation of the patella (patella) is a common injury in teenagers. Treatment is possible with the help of rehabilitation or surgery.

Causes of patellar luxation

One of the most common causes of patellofemoral joint pain is impaired movement of the patella in the intercondylar groove. The quadriceps heads and ligaments help center the patella in the intercondylar groove of the femur during movement. For various reasons, an imbalance in the traction of the muscles is possible, as a result of which one of the heads pulls the patella more than the other. This, in turn, causes a large pressure of the patella on the articular cartilage of the intercondylar groove on one side compared to the other. Constant asymmetric pressure leads to damage to the articular cartilage. In this case, the cartilage in the outer part experiences more pressure during movements. If such an effect occurs for a long time, softening begins first, and then the destruction of the cartilage. This phenomenon is called chondromalacia patella.

Finally, dislocation of the patella can occur if one of the walls of the intercondylar sulcus (usually the outer one) is less developed than the inner one, or the depth of the intercondylar sulcus is not sufficient to keep the patella from dislocation. In these cases, the patella also tends to dislocate from the joint. With repeated dislocations, rapid degeneration of the cartilage of the femur and patella occurs and causes persistent pain in the patient. It is worth noting that dislocations and subluxations tend to recur as the surrounding patella-supporting ligaments are stretched or damaged and the femoral condyles wear away. Complications of dislocation of the patella can be considered subchondral fractures.

Conservative treatment

After patellar luxation, the main goal of treatment is to restore the ability of the knee joint to normal functioning and restore its strength in order to avoid repeated displacements of the patella.

In case of traumatic dislocation, it is necessary to free the knee joint from blood and provide it with rest. It is recommended to apply cold. After a few days, rehabilitation begins, the goal of which is to restore the normal functioning of the knee and the breadth of the range of motion. At the initial stage, it is recommended to use a fixing knee brace. The main goal of rehabilitation is to strengthen the hip extensor muscles, as the extensor force of the knee passes through the patella.

In some patients, the recovery process occurs due to proper rehabilitation, i.e. through conservative treatment. Other patients may have problems, of which the most unpleasant is recurrent patellar dislocations.