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Knee Instability and dislocations


What is Knee instability/dislocation?

It is a problem whereby the knee cap (patella) comes out of its normal groove that it glides in. It is often caused by a sudden blow to the knee or by a rapid change in direction. It is possible for the knee cap to come out and go back in spontaneously (subluxation) or to stay out requiring urgent relocation (dislocation).  Some people are prone to this happening and usually there are anatomical or hereditary causes that are responsible. In this case extensive rehabilitation or stabilisation may be required. However, in the vast majority of cases patients require advice and a rehabilitation programme.

What causes knee instability?

There are several causes as to why kneecaps dislocate, and these can be divided into anatomical factors and patient factors. Patient factors usually are as result of trauma. Anatomical factors are due to the patient’s bone shape, abnormalities in bone development, laxity of ligaments. Often the cause is multifactorial, thus at Total Orthopaedics we undertake a complete assessment of your whole leg biomechanics to determine what treatment is necessary. 

How is Knee Instability diagnosed?

Knee Instability is primarily diagnosed on the basis of the patient’s history and physical examination. Investigations are then usually required to identify both the cause of the dislocation and any subsequent damage that may have occurred. X-rays, CT scans and MRI’s may be required particularly for recurrent dislocations or if surgery is being considered.

Treatment and recovery

In the acute situation if a dislocated knee cap has not reduced itself you need to go straight to the emergency department as urgent reduction is required. After this stage X-rays and usually scans are required for the assessment of any damage to the underlying structures. Initial treatment is to let the ligaments settle and commence rehabilitation. 

It is often worth seeking an early opinion to gain a better understanding of the anatomy and the likelihood of it reoccurring.  There is a risk each time the knee cap dislocates that more damage is done to the cartilage lining the back of the knee cap.

Rehabilitation is the mainstay of treatment for the vast majority of patients, but there are some where surgical stabilisation may be required – particularly those with hereditary or anatomical predispositions. At Total Orthopaedics we can give advice on the best course of action.

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