Introduction:

Knee dislocation, also known as patello-femoral dislocation, is a condition in which the kneecap (patella) slips out of its normal position, usually towards the outer side of the knee joint. This displacement can cause significant pain and instability in the knee. In severe cases, surgical intervention may be necessary to restore stability and function. This article explores the diagnosis and treatment options for knee dislocation, including surgical approaches.

What is Knee (Patello-femoral) Dislocation?

Knee dislocation occurs when the patella is forced out of its groove, located at the end of the femur. This misalignment can be caused by a sudden twist or impact to the knee, as commonly seen in sports injuries or accidents. Individuals with certain anatomical factors, such as shallow grooves or ligament laxity, may be more prone to patellar dislocation.

How is a Dislocated Knee-cap Diagnosed?

Diagnosing a dislocated knee-cap typically involves a comprehensive evaluation by a healthcare professional. If the cause is traumatic i.e. during sports, then the disgnosis can be quite obvious as well as gruesome, with the knee cap sitting out of its usual place on the side of the femur. This is very painful and sometimes the patella spontaneously goes back to the front of the knee. Sometimes it is stuck and requires reduction under sedation usually in the ambulance or in A+E.

Further examination may include a detailed medical history, physical assessment, and imaging studies. X-rays and magnetic resonance imaging (MRI) scans can provide detailed images of the knee joint, helping to confirm the diagnosis and assess any associated damage to the bones, ligaments, or cartilage.

Common symptoms of knee dislocation include:

1. Acute pain in the knee, especially after a sudden movement or impact.
2. Swelling and tenderness around the kneecap.
3. Limited range of motion and difficulty in straightening or bending the knee.
4. Instability or a feeling of the knee "giving way."
5. Popping or grinding sensations during movement.

How is a Dislocated Knee-cap Treated?

The treatment approach for knee dislocation depends on the severity of the injury and the patient's specific circumstances. Initial management often involves nonsurgical methods, including:

1. Closed reduction: The healthcare provider may gently manoeuvre the kneecap back into its proper position using manual manipulation techniques.
2. Immobilization: A brace or cast may be prescribed to immobilize the knee and allow the damaged structures to heal. Crutches may be necessary to keep weight off the affected leg during the recovery period.
3. Physical therapy: Rehabilitation exercises help restore strength, flexibility, and stability to the knee focusing on Quadriceps strength.. This can help prevent future dislocations and promote overall knee health.

In cases of recurrent or severe patello-femoral dislocation, surgical intervention may be recommended. The specific surgical procedure will depend on the individual's condition, but commonly used techniques include:

1. Medial patellofemoral ligament (MPFL) reconstruction: This procedure involves repairing or reconstructing the ligament responsible for stabilizing the patella. It can be done using various surgical approaches and may involve using grafts to strengthen the ligament.
2. Tibial tubercle osteotomy: In some cases, realignment surgery may be necessary to correct underlying anatomical abnormalities contributing to dislocation. A tibial tubercle osteotomy involves repositioning the bony attachment of the patellar tendon to improve stability.
3. Trochleoplasty: When the groove at the front of the femur is too shallow or indeed flat or domed (this is known as Trochlear dysplasia); an operation to create a deeper groove is carried out

Is Knee Dislocation Surgery (Patello-femoral Stabilization) Painful?

During knee dislocation surgery, patients are placed under anesthesia to ensure comfort and a pain-free experience. After the surgery, the level of pain or discomfort can vary from person to person. However, healthcare professionals will prescribe pain medications and provide appropriate post-operative care instructions to manage any discomfort effectively.

Conclusion:

Knee dislocation, or patello-femoral dislocation, can be a distressing condition that affects mobility and quality of life. While non-surgical treatments are often the first line of management, some cases may require surgical intervention to restore stability and prevent recurrent dislocations. Consulting with a skilled knee surgeon in Manchester, preferably from a reputable knee clinic, is essential to ensure accurate diagnosis, personalized treatment plans, and optimal outcomes. If you experience knee patellar dislocation, it is crucial to seek medical attention promptly for timely diagnosis and appropriate treatment to regain function and prevent long-term complications.

Summary

Knee dislocation, also known as patello-femoral dislocation, is a condition where the kneecap slips out of its normal position. Sports injuries, accidents, and anatomical factors can contribute to this condition. Diagnosis involves a thorough examination and imaging studies. Non-surgical treatments like closed reduction, immobilization, and physical therapy are commonly used. However, severe or recurrent dislocations may require surgical intervention, such as MPFL reconstruction, tibial tubercle osteotomy and Trochleoplasty, or any combination of the 3 opereations.. Knee dislocation surgery is typically performed under anaesthesia, and post-operative pain is managed with medications. Consultation with a skilled knee surgeon from a reputable knee clinic in Manchester is vital for accurate diagnosis and personalized treatment.

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