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A dislocated patella will not necessarily require surgery for a full recovery. Differences in the severity and mechanism of injury will affect the treatment decision, as will the degree of athletic activity that the patient wishes to pursue after treatment. The patella itself may be manually shifted back into place by a doctor, other dislocations will demand surgery to correct. However, patella dislocations may also cause collateral injuries. These are injuries that are caused as the patella is dislocated, such as bone fragmenting, slivers of which may become lodged in the joint. The severity of these surrounding injuries may range from minor disruptions to very damaging tears of the internal structure and surrounding ligaments.
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After the splint or brace is removed, physical therapy will be initiated to restore strength and correct alignment problems or muscle imbalances that may have contributed to the dislocation.
The goal of therapy is to re-establish a full range of motion in the knee with proper alignment or tracking of the patella.
Ongoing therapy rehabilitates the quadriceps and hamstrings, the muscles surrounding the knee which add strength and stability to the joint.
Therapists may recommend changes in activity and specialized bracing to support the knee during movement or while it is under stress.
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Orthotics
An orthotic insert fits inside a shoe and helps position the foot in an anatomically correct position while walking, running, or jumping. Frequently, abnormal foot motion and gait occurs as a result of over-pronation of the foot; most orthotics are used to treat this condition. Over-pronation is a tendency to roll the foot onto the inner edge, loading the inside of the foot and leaving the outer edge almost weightless. A professionally made orthotic insert will exactly contour to the bottom of the foot, and can compensate for over-pronation or other abnormal foot mechanics.
One of two construction methods may be used to create an orthotic; one utilizes a plaster mold of the entire foot to make a moderately rigid insert, the other utilizes a foam impression of the bottom of the foot, creating a more flexible insert. In either case, the finished product must be tilted with small wedges, while other accommodations are made to protect sensitive areas of the foot. The choice of orthotics and design will vary according to the expected use, foot type, and body weight.
Orthotics can be used to treat:
abnormal foot mechanics
patella dislocation or maltracking
patellar tendonitis
general knee pain
ankle instability
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Patella Supports
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Knee: Support
A knee support is a sleeve-like support that fits firmly around the knee. The support is used to reinforce the joint during motion
and provide compression to aid healing and reduce pain and swelling.
Patients suffering from knee strains or inflammation will usually be
directed to use a support during daily activities.
The thin and flexible construction of the support allows for normal
movement of the knee and also allows the support to be worn under
loose fitting clothing. To prevent harmful pressure to certain
structures, the support applies differing compression around the
knee. The sides of the joint receive intermittent pressure to help
stimulate blood flow while the rear of the support fits relatively
loose to prevent constriction of circulation. The kneecap is aided
in positioning, but remains free of compression to allow its natural
movement.
Knee supports can be used to treat:
Strains
Sprains
Inflammation
Chondromalacia patella
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Patients who suffer dislocations that cause severe damage to the joint and who also expect to return to highly active lifestyles are typically recommended to undergo surgery. Due to the damage of the surface of the knee joint and the supporting structures around the knee that can occur during a patella dislocation, surgery may be necessary to repair these structures in order to restore normal function of the knee.
A dislocated patella may require surgery to be correctly repositioned. In these cases, surgery will be immediately after the occurrence of the injury to reduce further damage to the knee.
Surgery will also be necessary to remove from the joint any bone or cartilage fragments that may have broken off during the dislocation. This procedure can be completed during the surgery to reposition the patella.
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Orthotics
An orthotic insert fits inside a shoe and helps position the foot in an anatomically correct position while walking, running, or jumping. Frequently, abnormal foot motion and gait occurs as a result of over-pronation of the foot; most orthotics are used to treat this condition. Over-pronation is a tendency to roll the foot onto the inner edge, loading the inside of the foot and leaving the outer edge almost weightless. A professionally made orthotic insert will exactly contour to the bottom of the foot, and can compensate for over-pronation or other abnormal foot mechanics.
One of two construction methods may be used to create an orthotic; one utilizes a plaster mold of the entire foot to make a moderately rigid insert, the other utilizes a foam impression of the bottom of the foot, creating a more flexible insert. In either case, the finished product must be tilted with small wedges, while other accommodations are made to protect sensitive areas of the foot. The choice of orthotics and design will vary according to the expected use, foot type, and body weight.
Orthotics can be used to treat:
abnormal foot mechanics
patella dislocation or maltracking
patellar tendonitis
general knee pain
ankle instability
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Knee Braces
Knee braces are used to help control movement in an injured or rehabilitating knee. Patients that have suffered ligament injuries will usually be required to wear a brace during the different stages of recovery. If the injury requires surgery, then the patient may initially be required to wear a post-operative brace. This type of brace is designed to minimize motion during the early period after knee surgery or a knee injury. During this time, the knee is attempting to heal and undesired motion could be harmful.
Upon return to sports requiring contact or side-to-side motions, a functional or ligament knee brace may be prescribed to provide support and protect the injured/reconstructed knee. These braces can be purchased as "off-the-shelf" or "custom-fit" braces. The "off-the-shelf" brace can be sized appropriately, so that the fit will allow the knee to move freely and comfortably with the knee's own natural motion. Custom fit braces are also available for the more difficult to fit patients.
Knee braces can be used to treat:
Pre-operative ACL/PCL ruptures or injuries
Non-surgical ACL/PCL injuries
General knee instability
Pre/post joint replacement with ligament instability
Grade II or III ligament sprains.
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Knee: Cold Therapy
Cold therapy is used to reduce pain and swelling and is a convenient method to apply cold to an injured or rehabilitating extremity, such as a knee or shoulder. A cuff fits like a sleeve around the extremity and utilizes cold water supplied by a connected thermos or canister to chill the extremity. Water flow into the cuff can be controlled by different mechanisms. The simplest way is gravity; elevating the canister fills the cuff and controls the amount of pressure against the extremity. Water flow may also be controlled by a pump which will automatically circulate the cold water to and from the cuff. After surgery or immediately following an injury, the canister should be refilled with cold water every one to two hours to maintain a proper temperature. The cold therapy may also be used during rehabilitation, especially after physical activity, reducing the inflammatory heat from exercise.
Cold therapy can be used to treat:
Knee, Shoulder, Elbow, Wrist and Hand, Back, Hip, and Foot & Ankle Injuries. Knee Examples include:
Pre-operative ACL/PCL injuries.
Non-surgical ACL/PCL injuries.
General knee pain or swelling.
Soft tissue injuries.
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This procedure does not require the use of implantable surgical hardware.
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| This procedure does not require the use of tissue transplants. |
About the Review Team
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