Patellar Subluxation

A subluxed patella can be difficult to diagnose. Generally, the patella dislocates laterally.
 
Symptoms:

• Edema (swelling)
• Pain and the sensation of the knee “giving way”
• Patients will generally report the initial injury occurred with a pivoting, twisting or cutting sports activity, such as football

Diagnosis:
A “skyline” or “sunrise” x-ray view can give a physician a good idea of displacement, if any. Clinically, a patient will present with medial knee pain, swelling and/or a description of the knee “giving way.” Sometimes, the patella may appear higher than normal when the knee is flexed (bent). This condition is known as patella alta.
 
Treatment:
Treatment is aimed at improving the extensor mechanism (muscles in the thigh) so that the knee (patella) can track in better alignment.
 
Immobilization of an acutely subluxed patella will run a 4-6 week course concurrently with the use of cryotherapy (ice) to control edema and pain. Later, a course of therapy emphasizing strengthening of the quadriceps group will generally be prescribed.
 
Strengthening of this area will greatly aid in decreasing future susceptibility to dislocations.
 
If however, recurrent dislocation occurs, surgery may become an option. The extensor mechanism may need to be addressed through a variety of surgical procedures. The goal is to realign the patella and prevent lateral tracking problems from recurring.

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