Dislocation of the patella is an unpleasant pathological condition in which a person has a displacement of the patella.
Structure of the joint
So, the presented joint is one of the most mobile and loaded in the human body. It consists of an oval bone (patella) that covers the muscles and ligaments, protecting them from damage.
Her balance is provided by the ligaments of the quadriceps femoris, her own ligament, as well as other muscles.
The ligament of the patella, as well as the bone itself, plays a big role in the movement of the limb. These articulations provide the quadriceps with sufficient force to flex the leg. Any injury to this part of the knee is fraught with serious complications, as well as limited mobility of a person.
Types of pathology
Dislocation of the patella can be classified as follows:
- Innate. This type of pathology is extremely rare. The main reason for this condition is the insufficient development of the tissues from which the joint is built.
- Traumatic, or acquired. In this case, damage is caused by a fall or a direct blow. If the displacement of the patella occurs more than once a year and is periodic, then the dislocation in this case can be called habitual.
In addition, the pathology is acute and chronic. And you can also classify dislocation according to the direction of displacement of the bone:
- Rotary. The patella is displaced around its axis.
- Side. It appears as a result of a fall on an extended shin or a blow.
- Vertical. This type of injury is extremely rare. The bone here shifts in a horizontal plane and enters the joint space.
And you can also divide the pathology according to the degree of bone displacement:
- Easy. In this case, the patient practically does not feel pain, and the injury itself can only be detected during a doctor's examination, by chance.
- Average. Here the gait of the victim is already changing, he may often fall.
- Heavy. It is characterized by very severe pain, as well as complete limitation of leg mobility. The muscles of the thigh are strongly stretched, and the person's he alth is deteriorating.
Causes of the disease
Dislocation of the patella can be provoked:
- Direct injury (side impact, sharp turn).
- A defect in the articulation structure.
- Too strong muscle tension.
- Physiological characteristics of the body.
- Inflammatory degenerative disease of the knee.
- Surgical intervention on the joint.
- Condylar dysplasiahips.
- Falling from a height.
Also, the patellar ligament may not perform well enough. These causes of dislocation of the patella are quite common. However, they too can be prevented.
Symptoms of pathology
Before starting treatment, it is necessary to understand how the pathology manifests itself. So, if a person has a dislocated patella, the symptoms are:
- Severe and sharp pain appears in the injured area.
- Deformation of the patella occurs.
- Obvious displacement of the patella to the side or up and down.
- A person cannot bend or unbend the knee, lean on the leg.
- Unpleasant sensations gradually increase.
- Appearance of edema in the affected area.
- Redness of the skin.
- Feeling of instability in the joint.
- Increased temperature in the area of the affected joint.
If you experience one or more of these symptoms, you should immediately consult a doctor. Otherwise, the victim can expect serious complications. Also, do not set the patella yourself, as you can make it worse.
Diagnostic features
Naturally, the patient needs to undergo a thorough differential examination. The fact is that it is necessary to distinguish between dislocation and fracture of the patella, as well as to exclude other pathologies. Diagnostics involves the use ofmethods:
- External examination of the patient, palpation of the injured knee, and fixation of complaints.
- X-ray. Moreover, it is necessary to make a comparative picture of both joints. X-ray is done in several projections.
- MRI. The procedure allows you to get the maximum clinical picture, which will make it possible to prescribe effective therapy.
- Arthroscopy. This procedure is both diagnostic and therapeutic at the same time. It is used for research if other methods turned out to be uninformative.
Based on the information received, the traumatologist or orthopedist draws up a scheme for the treatment and rehabilitation of the patient.
Conservative treatment of dislocation
Immediately after an injury, ice should be applied to the injured area. This will calm internal bleeding (if any), relieve swelling and reduce pain. Naturally, it is better to immobilize the limb 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, the injection method of administering the drug is used, as it provides a quick effect.
- The patella must be carefully adjusted to avoid damaging the cartilage and increasing the risk of complications.
- A fixing bandage or plaster should be applied to the leg. The duration of its use is 6 weeks.
- The joint should be warmed up using UHF through plaster.
- After the bandage is removed, the specialistperforms a control X-ray examination.
- Followed by a period of restoration of the functionality of the joint.
Surgery
If the patient has a fracture of the patella, or if conservative therapy is ineffective, surgery is used. The surgeon performs a puncture of the joint, removing the accumulated fluid 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 these types of surgery:
- Open plastic of the medial ligament.
- Arthroscopy.
- Transposition of distal ligament attachment.
Early and correct operation can eliminate hemarthrosis, damaged parts of cartilage tissue, suture and fix the joint capsule. It should be noted that if the dislocation is accompanied by a rupture of the ligaments, then it is impossible to sew them together. Artificial or donor tissue is used to restore joint mobility.
The expediency and necessity of surgical intervention is determined by the doctor.
Injury rehabilitation
The recovery process should take place under the close supervision of an orthopedist. Rehabilitation includes feasible loads on the damaged joint, strengthening muscles, massage, and physiotherapy.
The patient is selected an individual set of physical exercises that will restore the range of motion and functionalityknees in full. Naturally, you should not overload the joint too much, especially in the postoperative period. For muscle training, flexion and extension exercises of the limb are used. In this case, the angle should not be large.
During the rehabilitation of the knee joint, the patient can use special fixing bandages that will not allow the cup to move again.
Prevention of pathology and possible complications
To avoid dislocation of the patella, the following preventive measures are required:
- Perform simple physical exercises every day to help strengthen the muscles and ligaments that hold the kneecap.
- It is better to avoid sudden movements and heavy stress on the joint.
- With a genetic predisposition or joint deformity, it is better to give up dancing, skiing, jumping.
If a person is diagnosed with a dislocation of the patella, treatment must be carried out without fail. Otherwise, complications are possible. For example, a patient begins to develop arthrosis of the knee joint. In addition, dislocation may become habitual. That is, the patella will shift even from minor physical exertion. In this case, the therapy becomes somewhat more complicated.
Another complication of the pathology is degeneration of ligaments and cartilage. The patient has weakness in the muscles, which makes it almost impossible to move the leg.
In case of proper treatment and effective rehabilitation, the prognosisfavorable pathology. That is, the functionality of the joint is restored completely. However, it is better to avoid those factors that can provoke a repetition of the displacement. Stay he althy!
