Dislocation of the patella: causes, symptoms, treatment and rehabilitation

The dislocation of the patella is an unpleasant pathological condition in which a knee cap is displaced from the person.

Structure of the joint

So, the represented joint is one of thethe most mobile and loaded in the human body. It includes an oval bone (patella), which covers the muscles and ligaments, protecting them from damage.

Its balance is ensured by the ligaments of the quadriceps muscle of the thigh, its own ligament, and also by other muscles.

Bundle of patella, as well as bone itself playsa great role in limb movement. These joint elements provide the quadriceps muscle with sufficient force to bend the leg. Any injury to this part of the knee is fraught with serious complications, as well as restriction of human mobility.

Types of pathology

The dislocation of the patella can be classified as follows:

Congenital. This type of pathology is extremely rare. The main cause of this condition is considered insufficient development of tissues, of which the joint was built.
Traumatic, or acquired. In this case, the damage results from a fall or direct impact. If the patellar bias occurs more than once a year and is periodic, then a dislocation in this case can be called habitual.

In addition, the pathology is acute and chronic. And you can classify the dislocation in the direction of bone displacement:

Rotary. The patella moves around its axis.
Side. It appears as a result of a fall on the unbent shin or stroke.
Vertical. This type of injury is extremely rare. The bone here shifts in the horizontal plane and enters the joint space.

And still it is possible to divide a pathology on degree of displacement of a bone:

Easy. In this case, the patient practically does not feel pain, and the trauma itself can be detected only when examined by a doctor, by accident.
Average. Here the gait of the victim is already changing, he can often fall.
Heavy. It is characterized by very severe pain, as well as a complete restriction of leg mobility. Muscles of the thigh are tightened, but the person's health is deteriorating.

Causes of the disease

A patellar dislocation can be provoked:

Direct injury (side impact, sharp turn).
Defect in the structure of the joint.
Too much muscle tension.
Physiological features of the body.
Inflammatory degenerative knee diseases.
Operative intervention on the joint.
Dysplasia of the condyle of the thigh.
Falling from a height.

In addition, the patellar ligament may not perform its functions well enough. These causes of patella dislocation are quite common. However, they can also be warned.

Symptomatology of pathology

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Before starting treatment, it is necessary to understand how pathology manifests itself. So, if a man has a dislocation of the patella, the symptoms are as follows:

In the injured area there is a strong and sharp pain.
The knee cap is deformed.
An obvious patellar shift to the side or up and down.
A person can not bend or unbend a knee, lean on his leg.
Unpleasant feelings are gradually amplified.
The appearance of edema in the affected area.
Redness of the skin.
Sensation of instability of the joint.
Increased temperature in the area of the affected joint.

If one or more ofpresented symptoms, you should immediately contact your doctor. Otherwise, the patient can expect serious complications. Also, do not patch the patella yourself, because you can make it even worse.

Diagnostic features

Naturally, the patient must passcareful differential examination. The point is that it is necessary to distinguish the dislocation and fracture of the patella, and also to exclude other pathologies. Diagnosis involves the use of such methods:

External examination of the patient, palpation of the injured knee, and fixation of complaints.
Radiography. And it is necessary to make a comparative picture of both joints. X-rays are made in several projections.
MRI. The procedure allows you to get the maximum clinical picture, which will give an opportunity to prescribe effective therapy.
Arthroscopy. This procedure is both diagnostic and therapeutic at the same time. It is used for research if other methods have proved to be of little informative.

Based on the information received, a traumatologist or orthopedist will describe the scheme of treatment and rehabilitation of the patient.

Conservative treatment of dislocation

Immediately after getting injured to the damagedplace it is necessary to apply cold. This will calm down internal bleeding (if any), relieve swelling and reduce pain syndrome. Naturally, the limb is better to immobilize and call a doctor or go to the emergency room.

Further actions of doctors are as follows:

The injured part of the leg should be anesthetized. In this case, an injection method is used, since it provides a quick effect.
The patella should be carefully adjusted so as not to damage the cartilage and not increase the risk of complications.
On the foot you need to impose a fixative bandage or gypsum. The duration of its application is 6 weeks.
Through gypsum, the joint should be heated with UHF.
After the bandage is removed, the specialist makes a control X-ray study.
Next follows the period of restoration of the functionality of the joint.

Operative intervention

If the patient has a fracturepatella, or conservative therapy was ineffective, surgery is used. The surgeon makes a puncture of the joint, removing the accumulated liquid inside it. After the intervention, the patient will have to undergo another course of recovery, the duration of which is at least 9 weeks.

There are such types of surgery:

Open plastic of the medial ligament.
Arthroscopy.
Transposition of the distal attachment of the ligament.

Early and correct operation is possibleto eliminate hemarthrosis, damaged parts of cartilaginous tissue, to sew and fix the joint capsule. It should be noted that if a dislocation is accompanied by a rupture of ligaments, then it is impossible to sew them. To restore the mobility of the joint, artificial or donor tissue is used.

The expediency and necessity of carrying out the surgical intervention is determined by the doctor.

Rehabilitation after trauma

The process of restoration should take place underattentive control of the orthopedist. Rehabilitation includes the feasible load on the damaged joint, strengthening muscles, massage, as well as physiotherapy procedures.

The patient is selected individual complexphysical exercises, which will restore the amplitude of movements and functionality of the knee in full. Naturally, do not overload the articulation too much, especially during the postoperative period. For muscle training, flexion and extension exercises are used. In this case, the angle should not be large.

During rehabilitation of the knee joint, the patient can use special fixing bandages, which will not allow the cup to move again.

Prevention of pathology and possible complications

To dislocation of the patella did not occur, it is required to observe such preventive measures:

Every day you need to perform simple physical exercises that will help strengthen the muscles and ligaments that hold the knee cap.
It is better to avoid sudden movements and a heavy load on the joint.
With genetic predisposition or deformity of the joint, it is better to give up dancing, skiing, jumping.

If a person is diagnosed with a dislocationpatella, treatment must be made without fail. Otherwise, complications are possible. For example, the patient begins to develop arthrosis of the knee joint. In addition, the dislocation can become habitual. That is, the patella will shift even from a slight physical exertion. In this case, the therapy becomes somewhat more complicated.

Another complication of the pathology is dystrophy of ligaments and cartilaginous tissue. The patient has weakness in the muscles, which almost does not allow you to move your foot.

In case of proper treatment and effectiverehabilitation pathology prognosis favorable. That is, the functionality of the joint is fully restored. However, it is better to avoid those factors that can provoke a repetition of the displacement. Be healthy!

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