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The Case of the Wandering Kneecap

Kneecap dislocation occurs when the patella, or kneecap, slides to the outside of the joint, thus stretching and possibly tearing the ligaments that hold it in place. The patella is probably the most commonly dislocated bone in the body, with kneecap dislocation occurring most often in teenage athletes and adult women.

Kneecap dislocations fall into two categories.  Those involving an accident, such as a blow to or a twisting of the knee, are called traumatic dislocations. Atraumatic dislocations occur when the person is “loose-jointed” or the kneecap is misaligned (tilted or shifted), thus making the joint less stable.

Symptoms of a dislocated kneecap include:

• bleeding under the patella

• bruising around the patella

• swelling of the kneecap

• tenderness along the edge of the patella

• pain and clicking when the patella pops out of its groove and then moves back into place

• actual dislocation of the patella when it moves out of the groove and gets stuck out there

Surgery is required when significant damage, such as muscle rupture, bone fracture or detachment of the ligaments, occurs or when kneecap injuries become recurrent. When recurrent injuries or serious damage are not involved, however, the patient usually engages in protective rehabilitation for three to five weeks to prevent the kneecap from moving laterally and relieve pain.

The second phase of kneecap rehabilitation, which should take anywhere from two to four months, involves rebuilding and strengthening the quadriceps muscle to prevent dislocation from happening again. We will be glad to design an individual rehabilitation program that will address your particular needs and get this complex joint functioning smoothly and strongly once more.

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