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Patellar DislocationAka: Patellar Subluxation
- Epidemiology
- More common in teenage girls and young women
- Associated with increased Q-Angle (see below)
- More common in teenage girls and young women
- Mechanism
- Forceful deceleration with concurrent knee rotation or
- Valgus force with strong quadriceps contraction
- Results in lateral patella displacement out of groove
- Predisposing factors
- Miserable Malalignment Syndrome
- Tight lateral retinaculum
- Patella Alta
- Patella hypermobility
- Vastus lateralis hypertrophy
- Symptoms
- Anterior knee ripping or tearing sensation at injury
- Knee flexes with dislocation
- Patella relocates with knee extension
- Subluxation associated with giving way sensation
- Signs
- Knee held in semi-flexed position
- Dislocation
- Concurrent osteochondral Fracture in 28-52% patients
- Associated with Anterior Cruciate Ligament Tear
- Subluxation
- Instability and weakness
- Reluctant to bear weight
- Predisposing factors
- Examine for predisposing factors listed above
- J-Sign
- Quadriceps angle (Q-Angle) >15 degrees
- Radiology: Knee XRay
- Management
- Patella reduction (if still dislocated)
- Gentle knee extension and
- Gentle lateral patella pressure
- Bracing and taping
- Alter aggravating activity
- Physical Therapy and Rehabilitation
- Soft tissue and patellar mobilization
- Muscle strength
- Vastus medialis oblique
- Gluteus
- Foot and ankle
- Consider immobilization
- Indications
- First patella dislocation and
- No significant Vastus Medialis disruption
- Technique
- Immobilize for 6 weeks
- Knee in full extension
- Foam pad protects Vastus Medialis
- Lateral support holds patella medially
- Indications
- Maintenance
- Patellar stability program after rehabilitation
- Surgery Indications
- Inadequate improvement in 6 months
- Osteochondral Fracture
- Patella reduction (if still dislocated)
Patellar subluxation (C1839733) | |
|---|---|
| Concepts | Finding (T033) |
| English | Patellar subluxation |
| Sources | OMIM Derived from the NIH UMLS (Unified Medical Language System) |