Orthopedic Treatment For Kneecap Instability

by Craig W. Goodhart, MD 26. October 2016 08:23

Kneecap or Patella, is one of the three bones that constitute the knee joint. When the knee bends and straightens, the kneecap smoothly slides up and down within a v-shaped groove at the end of the thigh bone. Sometimes, due to a fall or a blow, the patella can dislocate, either completely or partially.

When the patella slides out of place, it causes pain and loss of activity. It is necessary to seek medical attention, even if the patella slides back into position on its own.

Causes

There are several causes that result in Kneecap Instability. People having an abnormality in the knee, are more prone to the condition. Some of the common causes of instability are:

  • The femur (thighbone) may be shallow or uneven, increasing the chances of dislocation.
  • Loose ligaments make the joints extremely flexible, thus increasing the chances of patellar dislocation. Girls are more prone to this type of kneecap instability in caparison to boys.
  • Children with cerebral palsy and Down syndrome have weak muscles. This may cause their kneecaps to dislocate frequently due to imbalance.
  • In some rare cases, children can be born with unstable kneecaps that cause their kneecaps to dislocate at a very young age. This is usually painless.

Symptoms

  • Shifting or sliding of the kneecap out of the grove
  • Sitting and simple activities cause pain
  • Patella usually dislocates with a popping sound
  • Swelling and/or stiffness
  • Deformity of the knee
  • Cracking sound on movement or while changing direction

Treatment

Non-surgical treatment

  • The first step in treating an unstable knee requires taking the child to the Emergency Room. The doctor may perform the ‘reduction’ treatment. This involves giving pain medication to the patient which helps relax the knee muscles. Then the doctor applies a gentle pressure to move the kneecap back into place. In some cases, reduction may occur naturally.
  • Wearing a brace. The doctor may recommend wearing a brace for about a month to help stabilize the knee, while it slowly heals.
  • Crutches. Putting weight on the knees can slow down the healing process and increase the pain in the knee. Thus, the doctor may suggest using crutches for a couple of weeks following the injury.
  • Once dislocated, the possibility of recurring instability of the kneecap increases. Regular exercises may help straighten the thigh muscles and reduces the risk.

Surgical treatment

In chronic cases, the patella may not stabilize with the help of non-surgical treatment. The doctor may recommend surgery to line up the kneecap into place and to tighten the loose tendons and knee muscles. The type of surgery depends on the extent of damage occurred.

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