Symptoms and treatment of patellar subluxation. Dislocation of the patella Patella luxation ligament damage

Displacement of the flat bone, which is located in front, from its proper place is a dislocation of the patella. Symptoms and treatment depend on the mechanism of dislocation: direct injury, excessive contraction of the quadriceps muscle during dynamic movement, which is typical for football and basketball. Patella dislocation is usually combined with the anterior cruciate ligament. The bone is pushed out more often to the outside. In this case, joint dislocation associated with displacement of the tibia relative to the femur does not occur. Patellar dislocation usually does not require surgical treatment, but if the displacement is severe, surgery is performed.

Patellar luxation is usually caused by injury or overuse of the joint. Dislocation occurs more often in women and is the most common injury among athletes.

The main causes of patellar dislocation are as follows:

Most often, patellar dislocation is a recurrent injury that occurs again after a displacement has occurred once. It is possible that the internal ligament or its own ligament is sprained, and the external one is overly strained.

Excess weight increases the risk of injury and stress on the joint. As the abdomen enlarges, pressure on the organs and vessels of the pelvis increases, which leads to hypotension of the quadriceps femoris muscle.

Types of pathology

Every sixth adult per 100 thousand experiences a dislocated patella; in adolescents the figure is 29 per 100 thousand. There are several types of dislocations:

1. Outer– lateral displacement of the patella, occurs most often when the knee joint is overloaded against the background of muscle imbalance.
2. Horizontal– rarely occurs, as it is associated with rotation of the patella around a horizontal axis with the articular surfaces facing proximally or distally.
3. Vertical– occurs as a result of rotation of the bone around a vertical axis with a splitting of one of the lateral surfaces in the intercondylar groove of the femur.
4. Intercondylar- dislocation in which the patella remains in the anatomical position, but rotates around a vertical or horizontal axis.

Congenital dislocation of the patella in a child is an anomaly in the development of the knee joint, detected before the age of three. For correction, tendon-muscle plastic surgery is performed.

The location of the tibial tubercle, the distance of the groove in the tibial tuberosity, the location of the posterior cruciate ligament, and the shape and size of the bone influence the risk of lateral dislocation.

Symptoms

Symptoms of a dislocation depend on the mechanism of injury, as well as the severity of the injury to the knee joint and associated injuries. In mild cases, knee function is restored immediately, in complex cases, pain occurs and mobility is limited.

Primary symptoms of patellar dislocation may include:

A visual increase in the size of the knee joint, pain and the inability to straighten the leg are signs of ligament damage or dislocation.

Diagnostics

To make a diagnosis, the traumatologist will ask clarifying questions about the injury, its nature, and previous history of injuries. It is important to talk about the nature of the pain during and after dislocation. Is it pulsating, sharp and painful, does it ease during rest. The ability to transfer body weight to the affected leg is clarified.

Examination of the knee joint includes:

A physical examination determines the presence of other knee injuries. The doctor tracks the trajectory of the patella during slow extension of the joint. When dislocated, it deviates from a straight line. The direction indicates the type of injury that occurred. Deterioration of bone mobility and increased pain with manual displacement also indicate the side of the dislocation.

X-rays are important in diagnosing patellar dislocation and determining the severity of the injury. The image shows the bone structure of the knee joint. In severe dislocations, due to intense swelling, the patella moves beyond its usual position. X-rays can reveal cracks and bone chips.

Magnetic resonance imaging is needed if damage to a ligament, tendon or cartilage is suspected.

Treatment

The choice of therapy depends on the type of dislocation - acute or habitual. In the first case, arthroplasty is required, in the second, it is possible to restore the medial patellofemoral ligament using the Yamamoto operation for a dislocated patella.

Conservative

When the patella is subluxated, treatment is carried out conservatively. The patient is prescribed rest for the knee joint, the use of ice compresses to relieve pain, swelling and inflammation. Ice wrapped in a towel should be applied every two hours for 15-20 minutes.

During the first days, nonsteroidal anti-inflammatory drugs, such as Nimesil or Ibuprofen, are prescribed to relieve pain.

Before sending the patient home, the doctor will manually adjust the patella until the leg begins to straighten.

In case of large swelling and accumulation of effusion, a needle is used to pump out the fluid. For an open wound, a sterile bandage must be applied.

Immobilization of the knee joint is important to prevent re-dislocation or injury. Special orthoses or elastic bandages are used; in severe cases, plaster or adhesive tape is applied. Sometimes you will have to use crutches for the first few days to reduce the load on the knee joint.

Operational

When ligaments, tendons, or cartilage are damaged, surgery is required to realign the patella and repair surrounding structures.

Arthroscopic surgery involves inserting instruments into the joint through small incisions to identify damage and assess the scope of work. After diagnosis, a reconstructive procedure is performed, which involves removing or fastening damaged cartilage, fixing the patella, and suturing ligaments and tendons.

Rehabilitation after injury

Recovery begins immediately after applying a cast or bandage. UHF and magnetic therapy are used for rapid tissue healing and regeneration. After removing the plaster, you need to restore the muscles with electrical stimulation; electrophoresis is used to supply blood to the knee joint.

Massage and gymnastics begin while still in a cast or splint: extension of the knee joint while sitting with a towel roll under the shin. This exercise strengthens the quadriceps femoris muscle. After removing the cast, an active massage of the muscles and their attachment points is prescribed. Exercises with a rubber expander and on an unstable support are used.

Prevention of pathology and possible complications

The main complication of a dislocation is habitual dislocation of the patella - one that is repeated many times after the first injury. The cause is instability of the joint, fixation of ligaments.

To reduce the risk of re-injury, prevention is carried out. Through manual muscle testing, a physiotherapist and kinesiologist identify hypotonic muscles, correct their tone, and strengthen them with exercises.

Sometimes, to recover from a dislocated patella and prevent dislocations, you need to work on the alignment of the knee joints: the patella should be located strictly above the 2nd and 3rd toes.

If this does not happen, then the femur or tibia is rotated, and correction of the muscle imbalance is required. Training on an unstable support helps, but only after visiting an osteopath.

Conclusion

Patella displacement occurs due to muscle imbalances and sports injuries. Treatment of mild dislocation will be conservative, and severe form – surgical. Rehabilitation after a dislocated patella avoids re-injury by correcting muscle imbalances.

In contact with

The most common displacement of the knee joints while maintaining their partial contact is subluxation of the patella. Unlike a dislocation, with a subluxation the functionality of the knee is partially lost. However, this disease also requires increased attention and treatment, because it can lead to serious consequences.

Sesamoid bones perform the functions of additional strengthening in the body of the joints most exposed to stress, and also serve to cushion and soften movements. The patella (or kneecap) is the largest sesamoid bone in the human body, located in the extensor tendon between the tibia and femur.

It is able to easily move during extension in anatomically permissible directions, and when flexed it fits into the groove between the bones, thereby protecting the surface of the tibia and femur from displacement. The lower portion of the patella is connected to the front of the tibia by a ligament called the patellar ligament.

Symptoms

Patellar subluxation can be congenital or acquired. The first is associated with anomalies in the intrauterine development of the knee joint. Acquired subluxations can be traumatic (which occur due to excessive stress) and pathological (which are a consequence of any disease of the musculoskeletal system).

The causes of subluxation are usually associated with playing sports, as well as falling on a hard surface. However, sometimes subluxation can develop after surgery, which leads to the development of an unstable position of the patella. Main symptoms:

• Feeling of limb instability;
• Crunching, clicking sounds accompanying movement;
• A feeling of sinking in the knee when trying to fully straighten the leg;
• Acute pain as a result of ligament rupture;
• Restricted mobility (the patient cannot bend and straighten the leg);
• Swelling, hemorrhages, hemarthrosis in the area of ​​injury;
• Changing the shape of the knee.

Rarely, traumatic shock may cause increased body temperature and pale skin.

Treatment

It is important to see a doctor as soon as possible, because the sooner a subluxation of the patella is detected, the faster the recovery will occur. First of all, the injury must be numbed. Then the traumatologist performs an examination and studies, including X-rays, MRI and CT scans of the knee. When diagnosing, attention is paid not only to the joint area, but also to soft tissues and nerve endings. If surgery is necessary, arthroscopy may be prescribed.

In most cases, if the kneecap is subluxated, surgery is not required. Manual reposition is performed, during which the doctor makes flexion-extension movements of the injured leg, thereby restoring the correct position of the patella.

After the manipulations, the knee is fixed with an orthosis or a plaster cast. During treatment, the patient must use crutches.

Operation

Surgery may be required in case of damage to the ligaments and tendons, changes in the knee joint that have a negative impact on the healing process, and also provoke repeated dislocations. Surgeries are also indicated in cases of chronic subluxations, when the injury is more than 3 weeks old.

Modern methods of treating patellar subluxation involve the use of an arthroscope, which is used to examine and evaluate the condition of the knee joint from the inside. Then a reposition is performed aimed at mobilizing the outer edge of the patella. The use of this method of treatment is the most effective and can significantly reduce the rehabilitation period.

Patellar subluxation with ligament rupture

The patella has two ligaments that hold it in place on the sides. The lateral ligament pulls the patella outward, and the dorsal ligament, on the contrary, pulls it inward. Thus, uniform tension of the ligaments prevents the patella from moving. As a result of excessive physical activity or a fall on a hard surface, displacement of the articular surfaces sometimes occurs with damage to the ligaments and joint capsule.

Too much stretching or tearing of the ligament with excessive tension on the external or excessive weakness of the internal ligament can lead to subluxation. As a result, the joint takes on an irregular shape and is easily dislocated during sudden movements (for example, when bending, falling, or physical activity).

Rehabilitation and recovery

It is important to begin developing the joint only after treatment. The rehabilitation is monitored by an orthopedic surgeon. Rehabilitation includes:

• Massage;
• Therapeutic exercises;
• Physiotherapeutic procedures;
• Wearing special bandages and bandages to restore joint function;
• Taking a complex of vitamins and minerals to restore the body.

Prevention of this injury is to strengthen the muscle frame, as well as the use of the basics of body grouping in the event of impacts or loss of balance. In addition, it is necessary to take precautions and, in case of potential stress, try to strengthen the knee with the help of special devices.

Consequences

As a rule, treatment for a subluxated patella lasts no more than 3 months and occurs without complications. In the absence of treatment and the transition of patellar subluxation to a chronic condition, there is a risk of complete dislocation, which in turn can develop into its usual form.

In these cases, conservative therapy is no longer effective and surgical intervention is required, which consists of strengthening the ligaments and changing their position.

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Description:

Patellar dislocations account for 0.4-0.7% of the total. The likelihood of patellar dislocation increases with a shallow patellar cavity, a poorly developed lateral femoral condyle, and a violation of the relationship between the axis of the quadriceps muscle and the patellar ligaments. Usually, until the moment of injury, these anatomical features do not appear in any way and go unnoticed.

Causes of patellar dislocation:

The likelihood of patellar dislocation increases with a shallow patellar cavity, a poorly developed lateral femoral condyle, and a violation of the relationship between the axis of the quadriceps muscle and the patellar ligaments. Usually, until the moment of injury, these anatomical features do not appear in any way and go unnoticed.
As a rule, the cause of patellar dislocation is direct trauma (a fall on the knee joint, a side blow to the patella area), combined with contraction of the quadriceps muscle. Lateral patellar dislocation usually occurs with the lower leg in extension. When bending the knee joint, lateral dislocation is practically impossible, since the kneecap is tightly pressed to the intercondylar surface of the femur. In rare cases, vertical dislocation of the patella may occur with a flexed shin.

Classification:

In traumatology, a distinction is made between acquired (traumatic) and congenital dislocations of the patella.

Depending on the duration of the injury, acute and chronic dislocation of the patella is distinguished. If the dislocation occurs repeatedly, they speak of a habitual dislocation.

According to the direction of displacement there are:
lateral dislocations of the patella (external and internal);
torsion (rotation) dislocations, in which the patella rotates around its vertical axis;
vertical dislocations, in which the patella rotates around its horizontal axis and wedges into the joint space between the tibia and femur.

Most often, external dislocation of the patella is observed, less often - internal dislocation. Torsion and vertical dislocations of the patella are extremely rare.

Symptoms of a luxated patella:

Acute traumatic dislocation of the patella is accompanied by severe pain. The knee joint is slightly bent, increased in volume, expanded in the transverse direction (with lateral dislocations). Active movements are impossible, passive movements are painful and severely limited.

The direction and degree of displacement of the patella is determined by palpation. With complete dislocation, the patella is located outward from the lateral condyle of the femur; with incomplete dislocation, it is located above the lateral condyle.

Sometimes a traumatic dislocation of the patella can be reduced on its own. Patients in such cases report an episode of sharp pain in the leg, which was accompanied by a feeling of buckling and displacement in the knee. After a self-reduced patellar dislocation, slight or moderate swelling in the knee joint area is observed. Hemarthrosis (accumulation of blood in the knee joint) is possible.

Diagnostics:

The diagnosis of patellar dislocation is made by a traumatologist based on the characteristic history, clinical picture and data. The most informative are comparative radiographs of both patellas, taken with the tangential direction of the X-rays from the front and from top to bottom or from bottom to top.

The basis for diagnosing habitual dislocation is repeated displacement of the patella that occurs without significant traumatic impact. Habitual and chronic patellar dislocations may be an indication for an MRI of the knee joint. When deciding whether the operation is advisable, a diagnostic arthroscopy of the knee joint is performed.

Treatment of patellar luxation:

Acute patellar dislocation is usually treated conservatively. The dislocation is reduced under local anesthesia. The limb is flexed at the hip joint (to relieve tension on the quadriceps tendons) and extended at the knee joint. Then the patella is carefully displaced until the dislocation is eliminated and a plaster cast is applied.

After reduction, a control x-ray is required to confirm the reduction of the dislocation and identify the osteochondral bodies that sometimes form during injury.

In case of acute dislocation of the patella, immobilization for a period of 4-6 weeks is indicated. Massage and physiotherapy are carried out under the supervision of a physiotherapist, without removing the splint. Full weight bearing on the leg is allowed one month after the injury.

Surgical treatment of acute patellar dislocation is carried out when osteochondral bodies are identified and there is a high probability of repeated dislocations due to changes in the knee joint.
Old and habitual dislocations of the patella are an indication for surgical treatment. After surgery, immobilization is indicated for a period of 4-6 weeks. Full range of motion in the knee joint is allowed after 8-10 weeks.

Dislocation and subluxation of the patella is a pathology in which there is a deviation in the position of the kneecap relative to the femur. If you miss the symptoms that should be an indication for immediate surgery, then correcting the situation will become impossible. But the best way to combat this pathology is to protect against traumatic factors, which become the main causes of patellar dislocation.

Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.

Dislocation or subluxation of the patella is a pathological change that can be either minor or very serious.

Important! The main difference between a subluxation is a slight restriction of joint mobility, while a complete dislocation leads to a 100% loss of functionality and the inability to move the leg.

With complete dislocation of the patella, the surfaces of the bones completely extend beyond the joint capsule and significantly change position. Externally, you can clearly see how the knee bends at an unnatural angle.

Subluxation develops against the background of patellar instability, which is formed due to certain factors:

• rupture of the lateral or dorsal ligament holding the patella, or their significant stretching;
• weakened thigh muscles, development of vastus muscle atrophy;
• congenital pathology of the structure of the limbs (the X-shaped structure of the legs leads to injuries and dislocations).

If any of these factors are present, severe loads, impacts and other external influences can lead to subluxation. Severe injuries significantly disrupt the position of the joint, leading to dislocation.

Reference! Recurvation of the knee joint is excessive flexibility of the joints, which leads to their change (turning the leg in the opposite direction). Usually diagnosed in women, it occurs less frequently in men.

Congenital dislocation of the patella is formed as a result of birth injuries and the development of recurvation of the knee joint. Acquired dislocation sometimes develops in children under 5 years of age as a result of rachitic damage to the musculoskeletal system.

Factors leading to dislocation

Ordinary daily activities, diseases and some injuries can provoke dislocation or subluxation of the patella:

• falling from any height - an unsuccessful landing even from a 1 meter fence can provoke subluxation;
• strong blows to the kneecap area;
• sudden turns of the body, especially after a long stay in one position;
• development of arthrosis of the knee joint;
• physiological characteristics of the patella being too high;
• surgeries performed on the knee or ligaments;
• congenital pathologies of bones and joints that daily injure the patella, forming a habitual dislocation.

Everything depends on the type of dislocation: treatment methods, rehabilitation, and even the type of surgical intervention.

Classification of patellar dislocations

Traumatology highlights several aspects of the classification of dislocations and subluxations. For any of them, the term habitual dislocation of the patella occurs - an injury that occurs for the second or even third time. The most common classification of dislocations is based on the direction of displacement of the cup:

• lateral dislocations - displacement occurs inward or outward;
• vertical - the patella, under the influence of external or internal factors, wedges into the joint space, turning around the horizontal axis of position;
• rotational (torsion) dislocations - the cup rotates around a vertical axis.

Most often in traumatology, external lateral dislocations are encountered, but rotational dislocations are diagnosed very rarely.

Important! Another classification involves dividing patellar dislocations into acquired and congenital.

Acquired dislocations occur as a result of external injuries and can be repeated several times under the influence of the same factors. Another dividing factor is how long ago the injury occurred. So, dislocations can be acute and old.

Symptoms of dislocation and subluxation

Determination of dislocation and subluxation is possible with the participation of a traumatologist, but there are symptoms that make it easy to assume the presence of such an injury:

• the kneecap swells, resulting in a visible deformity;
• Intense pain develops in the injured area; in case of complete dislocation, the ability to move disappears completely;
• it is impossible to lean on the sore leg;
• the knee practically does not bend or straighten;
• the skin turns red in the affected area.

When a dislocation occurs, the kneecap becomes floating and the shape of the leg takes on an unnatural appearance. In some cases, due to circulatory problems, the skin becomes pale.

Effective diagnostics

To identify injury, one or more non-invasive methods are prescribed:

1. MRI (magnetic resonance imaging) – needed to exclude fractures, ligament ruptures, hemorrhages and meniscal tears.
2. X-ray examination - provides accurate information about the location of damage from several sides.
3. CT (computed tomography).

Arthroscopy is used only if it is impossible to obtain information about the damage using standard methods. Arthroscopy uses a minimally invasive method (small damage, no large incisions).

An integrated approach to treatment

As soon as a luxating kneecap is suspected, a person should avoid putting any stress on the area. Cold compresses in the first minutes after injury will help get rid of severe pain and swelling. Then you need to see a doctor, who may recommend local injections for severe pain.

Important! At the appointment, the doctor may resort to the method of digital reduction of the patella. You cannot perform the procedure yourself.

After examination and reduction of the dislocation, a plaster cast is applied. It fixes the disc in a given position and prevents the damaged area from being injured again (due to increased sensitivity during the recovery period, even a small impact can lead to new damage). Fixation is applied from the ankle to the buttocks.

You will have to wear the cast for up to 5-6 months; it can be completely removed only after another x-ray. Additionally, while wearing the bandage, the doctor prescribes:

• physiotherapy (UHF through a bandage);
• massotherapy;
• additional vitamins and medications to stimulate healing.

Maintaining rest is the main principle of rapid restoration of damaged tissue. The minimum period of rest is 30 days.

Surgery

Surgery is prescribed if conservative treatment is impossible or ineffective. With the help of intervention, it is possible to correct a dislocation, eliminate congenital bone pathologies, and strengthen joint capsules and ligaments.

Another indication for surgery is frequent dislocations (from 3 per year). This type of operation is prescribed to young patients for congenital defects or to prevent pathology. In this case, surgical intervention can be of 2 types:

• arthroscopic surgery – suitable for mild displacement of the patella;
• open surgery – there are many techniques, the most suitable one is selected by the doctor.

The minimum recovery period is 7 days. With open operations, the period may increase by several weeks. During the first time, you need to be under 24-hour medical supervision.

Features of rehabilitation

After surgery or non-invasive reconstruction of the patella, therapeutic gymnastic exercises are prescribed, which should mobilize the movement of the joint and prevent the muscles from atrophying. Massage is prescribed a few days after the start of conservative treatment. The main purpose of the massage is to strengthen tissues, activate nutrition and blood circulation in the deep layers of muscles, tendons, and joints.

Lack of treatment can lead to consequences: the development of habitual dislocation and constant pain, as well as the gradual destruction of the ligaments and cartilage of the knee joint. Due to discomfort, motor function decreases and muscle weakness appears. Correct diagnosis, traumatological procedures, conservative treatment or surgery will prevent the development of any complications.

Why you can’t start treating a dislocated patella immediately after discovering the pathology

The knee is often injured because it is subjected to constant stress and undergoes very complex movements. It actually contains two joints: one (the main one) connects the bones of the thigh and lower leg; the second is the thigh and kneecap. Therefore, a dislocation of the knee joint may differ in its location, type and nature:

• When misalignment is diagnosed at the joint of the femur and tibia, it is usually called a knee luxation (subluxation).
• If the displacement occurs in the “second joint,” the kneecap, the injury is called a patellar luxation (subluxation).

A dislocation is a complete displacement of the articular bones, when they completely come out of the lock formed by the contacting surfaces, losing their guiding channel: the condyles of the epiphysis come out of the deepened plateau of the tibia; patella - from the anterior groove of the femur.

• If the displacement is incomplete, and the contact of the articular surfaces is partially preserved, such a dislocation is called incomplete (subluxation).
• Injuries of this kind can be closed, that is, not affecting the skin, and open, manifested in external damage.
• A dislocation is considered complicated if it is combined with damage to bones, meniscus, muscles, blood and nerve vessels.

In addition, dislocations are classified according to the reasons that caused them:

• mechanical (strong impact, sudden sudden movement, accident);
• pathological - caused by degenerative-dystrophic, inflammatory processes in the bones and osteopathies: arthrosis, osteoarthritis, osteoporosis, etc.;
• habitual (chronic) - occur due to the anatomical features of the musculoskeletal system;
• chronic - occur due to a primary, untreated injury;
• congenital - due to pathologies of bone development.

Complete and incomplete dislocation of the knee joint

Displacement of the knee joint (tibia relative to the thigh) is possible in all four directions: forward, backward, in the lateral directions - often inward.

The direction of displacement depends on which ligaments are damaged.

When an injury occurs, the following symptoms occur:

• sudden severe pain;
• swelling that occurs after some time;
• difficulty in some movements (it’s scary to take a step, bend your leg, lean on it);
• visible deformation and curvature;
• feeling of complete instability in the knee;
• skin redness, temperature.

In the photo this is what a person’s knee looks like after a dislocation.

A feeling of numbness, loss of sensation in the legs, cyanosis of the integument, sudden swelling of the lower leg are alarming signs of damage to the nerves and arteries.

A knee dislocation usually occurs when the collateral ligament and cruciate ligament are torn at the same time.

Knee subluxation can occur with isolated cruciate ligament injury.

The symptoms are more moderate:

• pain appears only during movement;
• swelling is mild;
• there is a feeling of slight instability;
• When walking, bending/extending the knee, crepitus (crunching) is possible.

Patella dislocation

Patella dislocation occurs when the patellar ligament or supporting ligaments are torn, and the kneecap is displaced laterally or posteriorly. Lateral displacements can be aggravated by hallux valgus or varus deformity of the legs:

• with valgus (X-shaped), the patella is more displaced outward;
• with varus (in the form of the letter O) - inward.

Symptoms of a patellar injury

When the cup comes completely out of the guide femoral groove, you may feel:

• sharp pain;
• a feeling that the patella is falling somewhere deep into the knee;
• the front of the knee swells;
• the knee locks during certain movements;
• a step is visible and palpated on the joint in the area of ​​the kneecap.

The pain usually subsides when the cup is adjusted.

With a minor injury and partial displacement (patellar subluxation), the symptoms may be vague in the form of slight discomfort and movement of the kneecap during flexion/extension.

What is a habitual dislocation?

Habitual dislocation of the knee joint is a periodic displacement of the associated bones caused by the specific characteristics of the musculoskeletal system. Most often this manifests itself in the prolapse of the patella.

Habitual dislocation of the patella occurs due to minimal daily loads, so it can be attributed to spontaneous displacement: the kneecap extends beyond the channel limited by the femoral groove. During movement, spontaneous return of the patella to the joint is possible. Usually one easily gets used to this phenomenon (hence the name of the injury “habitual”): patients know how to use specific movements in the knee to put the cup in place, or set it manually.

The reasons for habitual displacements lie:

• in natural increased elasticity of ligaments;
• muscle weakness;
• untreated rupture of the patella ligaments;
• the anterior ligament is too long, causing the patella to be positioned higher.

The consequences of habitual subluxation of the knee joint manifest themselves remotely in the form of the development of gonarthrosis, chondromalacia of the patella and other pathologies.

First aid for a dislocated knee joint

What to do if your knee is dislocated?

1. In the first minutes after the injury, you need to remove any weight from your leg, lie down on the sofa and put ice on the joint area - this will help prevent swelling.
2. It is advisable for the leg to lie on an elevated surface: to do this, you can place a pillow or a folded blanket under it.
3. In case of acute pain, the victim should be given analgesics (analgin, aspirin, diclofenac, ibuprofen, ketanol, etc.)
4. It is necessary to measure the patient’s pulse: weakness, poor fullness indicate possible compression of the vessels by the displaced bone. A feeling of coldness in the leg and poor sensitivity can strengthen the suspicion.
5. If there are signs that blood circulation is impaired, you can slightly pull the lower leg of the sore leg towards you: this will help partially alleviate the situation. But don't overdo it!

Treatment of a dislocated knee

When diagnosing, it is necessary to differentiate the injury from other injuries that give similar signs: fracture, meniscus tear.

• The traumatologist performs x-rays and, if necessary, angiography to check the blood vessels.
• If there is severe swelling in the knee, excess fluid is removed using a puncture.
• A dislocated joint is manually (stretched) set into place under local anesthesia, if there are no complications: ruptures of ligaments, menisci, blood vessels. To do this, the tibia is stretched, all articular surfaces are aligned according to their anatomical position, after which the tibia is returned to its place.
• If there are complications, surgery is performed.
• After all the steps taken, the knee joint is immobilized by applying an orthosis, a tight bandage or a plaster cast for a period of three to four weeks. Plaster is used as a last resort in case of complicated dislocation.

Treatment after immobilization continues:

It is necessary to use NSAIDs and other drugs prescribed by a doctor. It can be:

• angioprotectors;
• diuretics;
• antithrombosis agents;
• antidepressants;
• calcium supplements, vitamins, etc.

Without waiting for the orthosis to be removed, they engage in exercise therapy, performing exercises to strengthen the quadriceps, lateral and adductor muscles of the thigh.

If habitual dislocation of the patella occurs, treatment is carried out conservatively with the help of physical therapy. Here you need an experienced rehabilitation therapist who, based on the causes of chronic kneecap prolapse, will select special exercises: for example, stretching the quadriceps muscle, strengthening the anterior ligament and posterior muscles.

It is good to carry out physical therapy during the recovery period, after immobilization:

• UHF, laser/magnetic therapy; electrophoresis, massage, etc.

This will help develop the joint and prevent post-traumatic contractures.

Knee dislocation: treatment at home

Home treatment is a necessary part of recovery, which sometimes takes a long time. Typically, complete knee recovery occurs four months after the injury. But this period may increase with a complicated dislocation or with improper rehabilitation. People who experience a dislocation need to realize that any injury is not without consequences, and they have to patiently work on the joint so that it looks the same as before, without deformation or curvature. Therefore, you need to persistently continue physical exercise - this is the first condition for recovery.

In combination with exercises, deep penetration compresses are used:

• The most effective of them is dimexide, diluted half with water.
• Compresses made from pharmaceutical bile have a good effect on joints.
• Garlic and onion compresses are also effective: chop a head of garlic or onion, add a tablespoon of honey, put the mixture on a cloth, and then on the knee, covering it with a bandage on top.
• Curd compress soothes pain and nourishes joints.

It is also necessary to take hot baths with sea salt to relieve muscle spasms and contractures (almost inevitable consequences of dislocation). You can, while lying straight in the bathtub, bend and straighten your sore knee in water for 15 minutes.