CNY Orthopedic Sports Medicine, PC: Nonsurgical: Patella Malalignment/Dislocation
Injuries and Conditions : Knee : Patella Malalignment/Dislocation : Treatment : Non-Surgical : Conservative Treatment of Patella Malalignment
 
Overview
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.

Medication and Medical Products
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


    • Patella Supports
    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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    Long-Term Expectations for Recovery
  • The knee may be immobilized for up to six weeks. After that time, injured ligaments and tissue may take an additional six weeks to heal.
  • With physical therapy to recondition the surrounding muscles and reduce stiffness after immobility, a patient may expect to participate in athletic activities at their pre-injury level.
  • Patients that have not achieved full recovery will need to reduce their level of physical activity to prevent re-injury to the knee. In some cases this will mean completely eliminating certain activities that place particular stress on the knee.
  • Recovery is more dependent upon the condition of the joint and how the internal structures have repaired, than on the number of days, weeks or months since the injury occurred.

    • Possible Complications and Risks
  • Re-injury to the joint is possible if physical therapy becomes overly strenuous for the condition of the knee.
  • For patients with a severely dislocated patella which has caused damage to the internal structures of the knee, physical therapy may not sufficiently recondition or prepare the knee for vigorous athletic activities.
  • Dislocations may recur during activity if the injury has not completely healed.
  • Repeated dislocations may cause the knee to become arthritic and unstable.

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