Have you ever felt a 'pop' in your knee while playing, dancing, or suddenly twisting your leg? Have you ever felt a sharp pain as if your kneecap had gone sideways? Did you find yourself unable to walk? This is what we medically call a patella dislocation. Although it can be a scary experience, it is very easy to manage if you are aware of it. So, let's talk about it today.
Simply put, what does this kneecap jumping mean?
To understand this, let's first take a look at how our knee is made. It's very simple. Our knee joint is made up of three main bones.
1. Femur: This is the longest bone in your upper leg.
2. Lower leg bone (tibia): This is the thick bone that is below the knee and in front.
3. Kneecap (patella): This is the small, triangular bone in the front and middle of these two bones.
Think of it like a train on a railroad track. When we bend and straighten our legs, the kneecap (patella) moves up and down in a groove (we call it the `trochlear groove`) at the bottom of the thigh bone (femur). A network of tendons and ligaments helps keep it in this groove.
Patella dislocation is when the kneecap, for some reason, slips out of its trochlear groove. It can't move normally, and the knee becomes stiff and locked. Most of the time, it slips to the outside of the knee. Like any joint dislocation, it's very painful. But sometimes the kneecap can fall back into place on its own.
It is important to note that a patella dislocation is very different from a knee dislocation. A knee dislocation is a separation of the femur and tibia. It is a much more serious condition.
Also, when the kneecap is completely out of place, just a little, we call it (patella subluxation) .
There are two main ways to pop a kneecap.
We divide this situation into two main parts.
- Acute Patella Dislocation: This is the most common type of dislocation. It occurs when the kneecap suddenly dislocates due to an accident, fall, or collision. The kneecap may be less powerful than other joints.
- Congenital Patella Dislocation: This is a very rare condition. A child's kneecap develops outside of the trochlear groove. This is also called trochlear dysplasia .
How do you know if your kneecap has dislocated?
When a kneecap pops, you will usually see one or more of these symptoms. Let's look at them this way to understand them clearly.
| Symptom | What does that mean? |
|---|---|
| A 'tick' sound is heard. | This kind of sound can be heard when the kneecap pops out of its normal position. |
| Knees bend uncontrollably (Buckling) | Because the joint becomes unstable, your knee may suddenly buckle when you try to stand. |
| Unbearable severe pain | Stretching and tearing of ligaments and tendons causes severe pain. |
| Knee Swelling (Effusion) | The injury causes fluid to accumulate inside the joint and cause it to swell quickly. |
| Bluish/bruising | Damage to the small blood vessels inside can cause the skin to turn blue. |
| Knee lock | I am stuck in one position, unable to bend or straighten my knees. |
| I can't walk. | Pain and instability make it impossible to walk with weight on the leg. |
| The kneecap is visible to the side. | Even from the outside, you can see that the kneecap is not where it should be, but to the side. |
Could this have long-term effects?
Yes, there can be some long-term complications. Once the kneecap pops, the ligaments that hold the joint together are stretched, making the joint less stable . Also, the soft cartilage under the kneecap can be damaged. This increases the risk of developing knee osteoarthritis in the future.
Importantly, about 45% of people who have had a kneecap sprain will have it again. This can happen within a few weeks or even years later.
Why is the kneecap jumping like this?
The main reason for accidental jumps is the application of force. This can happen in two ways.
1. Direct Impact: A direct blow, collision, or hard fall to the knee can dislocate the kneecap.
2. Twisting Motion: This doesn't always have to be a major accident. Imagine that you're playing, dancing, or running and suddenly put your foot down and twist your body to the other side. When this happens, the lower leg stays in one place, causing the thigh bone to twist. The force of this can cause the kneecap to pop. This is common in athletes and dancers.
Additionally, some people are born with a loose ligament and tendon that holds their kneecap in place. We call this patellar instability . People like that can pop their kneecap with even the slightest movement.
Who is more at risk?
Although anyone can suffer a kneecap fracture in an accident, the risk is slightly higher for some people.
| Risk category | Reason |
|---|---|
| Players | Especially for those who play sports that put a lot of pressure on the knees (football, basketball). |
| Dancers | Because of the sudden twisting and jumping movements. |
| Young children (Teenagers) | Because joints and ligaments are a bit loose during rapid body growth. |
| Women | The lateral force on the knee increases due to the widening of the hip bone and the loose nature of the ligaments. |
| Tall men | Excess body weight puts more pressure on the joints. |
How exactly does the doctor find this?
Usually, a doctor can diagnose a kneecap sprain by examining your knee, asking you about the accident, and then examining your kneecap.
However, it is recommended to do several imaging tests to confirm if there is any other internal damage.
- Knee X-ray: Check for fractures in the bones.
- MRI scan: To look closely at the damage to ligaments, tendons, and cartilage.
- CT scan: Study in depth the subtle fractures and position of bones.
Sometimes the kneecap pops out and falls back into place on its own. You don't even realize it popped out. But the knee is swollen and painful. Even in cases like this, the doctor can use the scans mentioned above to determine if it's a pop or if there's any other damage.
What do you do when you have a kneecap dislocation? What are the treatments?
Treatment begins with resting the knee. Do not walk on it or do normal activities. You can apply ice to reduce pain and swelling, and take painkillers (e.g. NSAIDs) as prescribed by your doctor. In addition, your doctor will follow these treatment methods.
| Treatment method | Description |
|---|---|
| Reduction | The doctor will very carefully and gently put the kneecap back in place. This is called a closed reduction . If necessary, a small amount of painkiller or a sedative may be given. |
| Bracing and crutches | A brace/splint will be placed for a few weeks to stabilize the joint. You will be told to use crutches to keep your knee from putting weight on it. |
| Surgery | If there is significant damage to the bones, cartilage, or ligaments, or if the injury is sustained continuously, surgery may be recommended to repair them. |
| Rehabilitation | Physical therapy is a very important part of this treatment. It helps to strengthen the muscles around the joint, allowing it to move through a range of motion until it is stable again. |
Can't I fix this myself? Do I need to see a doctor?
Sometimes, when you slowly extend your leg, it may fall back into place. But if it's difficult to extend your leg because of pain, don't do it. A doctor can ease the pain and make it easier.
Most importantly: Even if you can fix it yourself, you should definitely see a doctor. It's essential to check for internal fractures, cartilage damage, or torn ligaments. Failure to do so can lead to bigger problems in the future.
If you feel your kneecap is unstable, have difficulty lifting your leg, have pain and swelling, or feel like your knee is getting stuck, be sure to seek medical advice.
How long does it take to heal?
This depends on the severity of your injury and the treatment method.
- For the first time, if there is no major damage: The recovery outlook is very good. Most people can return to normal daily activities within 6-8 weeks . They can start playing sports within 3-4 months .
- If you have had repeated falls or surgery: The recovery time will be even longer. It may take more than a year before you can return to playing sports.
How can we prevent this from happening again?
Once a joint is sprained, the ligaments are stretched, making it more likely to be sprained again if the same accident occurs. While it is difficult to prevent accidents, there are things we can do to reduce the risk.
- Do physical therapy correctly: Do the exercises for the prescribed period of time, as directed by your doctor and physical therapist. Don't rush into putting too much weight on your leg.
- Strengthen your leg muscles: Do exercises that strengthen the muscles around your knees (especially the front and back of your thighs). This will help prevent excessive stress on just one muscle group.
- Correct sports posture: If you are an athlete, have a specialist check your movements and posture to make sure they are correct.
- Considering surgery: If the ligaments in your knee are very loose, talk to your doctor about having surgery to strengthen them.
Does this hurt a lot? Can I walk after a kneecap pops out?
Yes, this is a very painful condition. You can't walk when the kneecap is dislocated. The knee is locked, or bends uncontrollably. If you try to put weight on it, the knee will 'buckle'. If it falls back into place, you may be able to walk, but there will be pain and swelling. So using crutches is the best option.
A kneecap dislocation can be a scary and painful experience. But with the right treatment and rehabilitation, you can make a full recovery and return to your normal life and sports activities. The most important thing is to follow your doctor's instructions.
Take-Home Message
- Patella dislocation is when the kneecap slips out of its normal groove.
- This is very painful, and at that point it is impossible to put weight on the leg and walk.
- Even if the kneecap falls back into place on its own, you should definitely see a doctor to check for internal fractures or ligament damage.
- Treatment includes rest, wearing a brace, and physical therapy. In some cases, surgery may be necessary.
- To prevent this from happening again, it is very important to do proper rehabilitation exercises and strengthen the muscles around the knee.
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