What is a Patellar Dislocation/Patellar Subluxation?

The kneecap, or patella bone, is anteriorly located on the knee joint and helps to protect and maintain proper mobility of the knee joint. This part of the knee is invaluable and is susceptible to injury and dislocation. An injury to the patella can misalign the kneecap and move this bone out of place. A patellar subluxation occurs when the kneecap is not fully dislocated yet. Without proper treatment, this can lead to a full Patellar Dislocation. In several sports activities like basketball and soccer, a kneecap dislocation may be a common injury as a result of overstretching of ligaments that surround the patella.

Symptoms of Patellar Dislocation

The kneecap can be easily seen in all patients, and its mobility easily tested. The patella should easily be able to be moved manually a few millimeters up and down and side to side. Many times, after an injury, the patient is able to see if their kneecap appears to be out of place or out of alignment with the rest of the joint. Or they will be able to feel that it is not tracking properly. Obvious visibility of a misaligned kneecap will not always be present, however. Many times, patients not only experience significant knee pain in the case of a dislocation, but there are other patellar dislocation symptoms that you need to be aware of. These symptoms include:

● The knee is misshapen or off-center
● The knee joint is swollen and tender, red or warm
● The knee is bent and you experience pain and the inability to straighten the leg
● A loose kneecap meaning that the patella’s movement side to side or up and down is much greater and feels looser than what is considered normal motion of the patella
● A completely immobile kneecap

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What causes Patellar Dislocations?

A sudden twisting, jerking or direct hit to the kneecap can cause chronic knee pain. In order to determine if the kneecap is injured, a proper diagnosis must be made by your physician. This will aid your physician in deciding on the proper route of treatment for your injury. The patella is held in place by the ligaments and cartilage that surround it. These ligaments connect the patella from the lower end of the thigh bone (femur) to the upper end of the shin bone (tibia). Patients who participate in contact sports or high-intensity workouts should be cautious of a patellar dislocation. A patellar dislocation can be caused by the following factors:

● Extreme stress put on the knee joint
● Rapid change of direction or motion in the knee
● injury to another portion of the knee such as Anterior Cruciate Ligament (ACL), Medial Collateral Ligament (MCL), etc.
● weak surrounding muscles leading to abnormal tracking of the patella when the quadriceps muscle is contracted

If the knee joint in overstretched or directly hit in any way, the kneecap is at risk of dislocating or subluxing. Subluxation is the step before dislocation. The pain-free patella should be positioned in the front and center of the knee itself. When walking or any other time that the quadriceps muscle is contracted, the patella should follow a painless path of movement that is referred to as ‘patellar tracking.’ There are special tests that your orthopedic doctor or physical therapist can perform to determine if the patella is tracking properly.

How Do I Prevent Patellar Dislocation?

The kneecap is there to protect and maintain proper motion of the rest of the knee joint, but it needs to be protected as well. Proper positioning and movement of the patella is critical to having a fully functioning knee. Patients can take precautions in their daily routines and during exercise activities. A patella dislocation diagnosis may be preventable if patients follow this advice:

● Stretch the knee joint every day in order to increase flexibility of all surrounding structures of the knee joint
● Properly warm-up before engaging in any form of strenuous activity
● Strengthen the muscles knee so that the patella is able to handle more pressure or weight placed on it. ● Strength training will not only increase the strength of the surrounding muscles but the bones as well, including the patella
● Wear knee pads when participating in contact sports and other advised protective equipment
● Avoid prolonged or frequent kneeling which can cause direct injury to the kneecap or a stretching of the surrounding articular structures leading to a loose kneecap
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