Dislocation of the knee or more specifically the patella is a common knee injury that is typically caused by a sudden trauma in the form of a twist or direct hit on the knee, causing the patella to pop out of its usual position in the femoral groove towards the end of the femur. Knee dislocation will be accompanied by a sudden acute pain followed by periods of immobility leading to disability. In order to treat it, open or arthroscopy surgery will be required to repair the damages.
Almost immediately following injury, the extent of injury will be unable to be determined accurately due to the swelling and pain present. Therefore, surgery will not be recommended until a few weeks later. In the mean time, physical therapy will need to be performed in order to strength the thigh and quad muscles to provide a better support and prevent muscle wastage. Once the injured knee is strengthened and swelling has subsided, knee dislocation surgery can then be carried out and there are many types out there:
In mild cases where the extent of injury is not severe and there is not much damage to the ligaments and tissues, bone realignment may be all that is needed. The tibial tubercle which is at the shin bone will simple have to be shifted and this will cause the position to be pulled towards the inner part of the knee.
Lateral release is a common type of knee surgery performed to stabilise the patellar. When the knee is dislocated, it pulls the knee cap to the outside of the knee. Lateral release surgery seeks to cut the retinaculum in order to centre the knee cap back into the grooves.
Reefing or medical imbrications is a surgical procedure performed with the intention to tighten the soft tissues that are located towards the inner portion of the knee. It is often done in conjunction with Lateral Release with the latter loosening the exterior part while the former tightening the interior part.
Trocheleoplasty is a less common surgery which works by deepening the grooves on the femur for the patellar. This will require the removal of some bone and increasing the depth of the grooves in which the patellar can then be held firmly in place with the aid of biodegradable stitches which will be reabsorbed into the body after a period of time.
Patellar dislocations can still happen after surgery but this is less than 5% of all cases. Patients are usually able to return to pre-injury level of activities after a couple of months if a disciplined recovery plan is followed religiously.
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