04/08/2025
๐๐๐ฉ๐๐ก๐ก๐๐ง ๐ฟ๐๐จ๐ก๐ค๐๐๐ฉ๐๐ค๐ฃ ๐๐๐๐๐๐๐ก๐๐ฉ๐๐ฉ๐๐ค๐ฃ
๐ What is Patellar Dislocation?
A patellar dislocation occurs when the kneecap (patella) slips out of its normal position, usually laterally, due to trauma or structural instability. It is most common in young athletes and may damage surrounding soft tissues like the medial patellofemoral ligament (MPFL), retinaculum, and articular cartilage.
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๐จ ๐พ๐ค๐ข๐ข๐ค๐ฃ ๐พ๐๐ช๐จ๐๐จ
1) Sudden twisting injury (pivoting sports)
2) Direct trauma to the knee
3) Hyperlaxity or ligamentous weakness
4) Shallow trochlear groove (dysplasia)
5) Weakness of vastus medialis oblique (VMO)
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๐พ๐ก๐๐ฃ๐๐๐๐ก ๐๐ง๐๐จ๐๐ฃ๐ฉ๐๐ฉ๐๐ค๐ฃ
1) Severe pain and swelling
2) Visible deformity (initially)
3) Difficulty bending or weight-bearing
4) Positive patellar apprehension test
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๐ฉบ ๐๐ค๐๐ก๐จ ๐ค๐ ๐๐๐ฎ๐จ๐๐ค๐ฉ๐๐๐ง๐๐ฅ๐ฎ
1. Reduce pain and inflammation
2. Restore full ROM (Range of Motion)
3. Strengthen quadriceps (especially VMO)
4. Improve patellar tracking
5. Prevent recurrence
6. Facilitate return to function and sport
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๐๏ธ ๐๐๐ฎ๐จ๐๐ค๐ฉ๐๐๐ง๐๐ฅ๐ฎ ๐๐๐๐จ๐๐จ
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๐น ๐๐๐๐จ๐ 1: ๐ผ๐๐ช๐ฉ๐ ๐๐๐๐จ๐ (0โ2 weeks)
โขGoals: Pain relief, inflammation control, joint protection
โขInterventions:
-Rest, ice, compression, elevation (RICE)
-Patellar brace or taping to prevent re-dislocation
-Isometric quadriceps contractions
-Gentle active-assisted ROM (0โ30ยฐ progressing gradually)
-Ankle pumps to prevent DVT
โขEducation: Avoid twisting and sudden knee movements
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๐น ๐๐๐๐จ๐ 2: ๐๐ช๐๐๐๐ช๐ฉ๐ ๐๐๐๐จ๐ (2โ6 weeks)
โขGoals: ROM improvement, initiate strengthening
โขInterventions:
-Full knee ROM exercises (heel slides, wall slides)
-Closed-chain quadriceps strengthening (mini squats, step-ups)
-VMO-specific activation: Biofeedback, electrical stimulation
-Proprioception training: balance board, single-leg stance
-Stationary cycling with minimal resistance
-Patellar mobilization (medial glide if safe)
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๐น ๐๐๐๐จ๐ 3: ๐๐ช๐ฃ๐๐ฉ๐๐ค๐ฃ๐๐ก ๐๐๐๐จ๐ (6โ12 weeks)
โขGoals: Normalize gait, build strength, enhance control
โขInterventions:
-Resistance band strengthening (hamstrings, quads, glutes)
-Lateral step-downs, lunges (progressively)
-Dynamic balance training
-Taping or bracing during activity
-Initiate sport-specific drills
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๐น ๐๐๐๐จ๐ 4: ๐๐๐ฉ๐ช๐ง๐ฃ ๐ฉ๐ค ๐๐ฅ๐ค๐ง๐ฉ Phase (3โ6 months)
โขGoals: Return to high-level function, prevent recurrence
โขInterventions:
-Plyometrics (jump squats, hopping drills)
-Agility training (ladder drills, shuttle runs)
-Eccentric control exercises
-Psychological readiness assessment
-Final clearance with functional tests (e.g., single-leg hop test)
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โ ๏ธ ๐๐๐ ๐๐ก๐๐๐จ ๐ฉ๐ค ๐๐ค๐ฃ๐๐ฉ๐ค๐ง
1) Persistent patellar instability or apprehension
2) Locking or catching โ may indicate cartilage injury
3) Pain on patellar compression (may suggest chondromalacia)
4) Recurrent dislocations โ refer for orthopedic evaluation (possible surgical need)
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๐ก ๐๐๐ฅ๐จ ๐๐ค๐ง ๐๐ช๐๐๐๐จ๐จ
1) Focus on neuromuscular control and proprioception
2) Encourage compliance with home exercise programs
3) Monitor for compensatory movement patterns
4) Educate about proper footwear and surface conditions during sports
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๐ ๐๐๐๐ฃ ๐ฉ๐ค ๐๐๐๐๐ง ๐๐ค๐ง ๐๐ช๐ง๐๐๐ง๐ฎ
1) Recurrent dislocations
2) Large osteochondral fragments
3) Failed conservative rehab (>3 months with persistent symptoms)