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Concept
Patellar dislocation
Summary
A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. Often the knee is partly bent, painful and swollen. The patella is also often felt and seen out of place. Complications may include a patella fracture or arthritis.
A patellar dislocation typically occurs when the knee is straight and the lower leg is bent outwards when twisting. Occasionally, it occurs when the knee is bent and the patella is struck directly. Commonly associated sports include soccer, gymnastics, and ice hockey. Dislocations nearly always occur away from the midline. Diagnosis is typically based on symptoms and supported by X-rays.
Reduction is generally done by pushing the patella towards the midline while straightening the knee. After reduction, the leg is generally splinted in a straight position for a few weeks. This is then followed by physical therapy. Surgery after a first dislocation is generally of unclear benefit. Surgery may be indicated in those cases where a fracture occurs within the joint or where the patella has repeatedly dislocated.
Patellar dislocations occur in about 6 per 100,000 people per year. They make up about 2% of knee injuries. It is most common in those 10 to 17 years old. Rates in males and females are similar. Recurrence after an initial dislocation occurs in about 30% of people.
People often describe pain as severe and being "inside the knee cap". The leg tends to flex even when relaxed. In some cases, the injured ligaments involved in patellar dislocation do not allow the leg to flex.
A predisposing factor is tightness in the tensor fasciae latae muscle and iliotibial tract in combination with a quadriceps imbalance between the vastus lateralis and vastus medialis muscles can play a large role, found, mainly, in women involved in sports. Moreover, women with patellofemoral pain may show increased Q-angle compared with women without patellofemoral pain.
Another cause of patellar symptoms is lateral patellar compression syndrome, which can be caused from lack of balance or inflammation in the joints.
Official source
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