What is the treatment for a patella dislocation?
It is strongly encouraged to seek medical attention by an orthopedic knee specialist, or another medical professional, in a timely manner if a patella dislocation is suspected.
A joint reduction technique will be performed in the event that the patella does not spontaneously return to its normal position after being dislocated. This technique should only be performed by a medical professional who is experienced in the manual manipulation of the patella back into the trochlear groove.
Non-surgical therapies alone are often successful for patients that sustained mild ligament injuries from a patella dislocation. A knee brace is applied after a successful patellar reduction to stabilize and protect the surrounding knee joint structures during the healing process. A combination of RICE (rest, ice, compression, elevation) and non-steroidal anti-inflammatory medications (NSAIDs) is recommended for pain and inflammation management. When appropriate, a physical rehabilitation program may be prescribed by Dr. Patel to restore mobility and strength to the knee joint.
In the event of failed conservative or non-surgical therapy, damage to multiple knee joint structures, or other extensive or complex knee injuries, surgical intervention may be necessary to restore the function of the knee joint. Because of the greater likelihood of future patella dislocations due to the disruption in ligament structure, Dr. Patel may implement one or more of the following surgical procedures to restabilize the patella and return patients to their normal daily activities.
- Lateral Retinaculum Release: The most common surgical treatment for patellar instability involves the release of the lateral retinaculum, a fibrous tissue found on the outer patella, to alleviate tension on the outer knee and helps to realign the kneecap.
- A new groove for the patella is created by reshaping the distal femur. This technique is typically reserved for patients with severe patellar instability.
- MPFL Reconstruction: The damaged portions of the medial patellofemoral ligament (MPFL) are excised and removed, and the remaining tissue is sutured back together. If there is not enough tissue remaining, a tissue graft, either from the patient (autograft) or donor tissue (allograft), can be implemented to provide a new surface for new tissue to grow.
- Medial Imbrication: This minimally invasive procedure, also known as reefing, tightens the tissues of the inner knee.
- Tibial Tubercle Osteotomy: This technique is performed for patients that experience a patella dislocation due to a shallow trochlear groove. To correct for this abnormal lower extremity alignment, the tibial tubercle (bony prominence of the shin bone) is shifted, with the patellar tendon still attached, to another position on the tibia often resulting in the patella being pulled inward.