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Author Topic: Dislocated patella  (Read 1326 times)

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Offline sapphireblue

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Dislocated patella
« on: March 08, 2012, 11:32:11 PM »
I've never had a knee or joint problem in my 33 years until last Friday.  I was walking across the room, reached for a toy for my son and out came my patella.  I was on the ground in a flash.  An ambulance was called and I was finally taken to hospital where it was reduced.  No real explanations or I was too drugged to really remember.  They gave me an immobilizer and crutches and told me I could bear weight as tolerated.  Xrays were done and there was no fracture. 

6 days later I am walking without crutches.  Physio told me I probably didn't need the immobilizer brace all the time but I'm terrified without it.  I feel like my knee is going to collapse.  (She suggested that I use the brace when my son is crawling around and take it off when he's napping.  She's afraid he'll start to fall or something and I'll lunge instinctively.) 

How long until I'm back to normal?  What can I expect along the way? 

I'm doing physiotherapy.  What else should/could I be doing to speed recovery? 

Is there a brace that will allow more movement but still provide support?

How much time should I be spending resting?  I don't want to overdo it and cause further injury. 

Does the length of time my patella was dislocated affect recovery time?  It was left dislocated for over 2 hours in total.  Is this time going to mean longer healing time?

Offline DennisKnee

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Re: Dislocated patella
« Reply #1 on: March 09, 2012, 10:05:22 AM »
Hey there,

I dislocated my kneecap late last year (29DEC11) and also needed to be taken to hospital to have it reduced. I did a fair bit of reading before my MRI less than 2 weeks later and as a result, had already prepared myself for the fact that I had a 99% chance of tearing my MPFL.

I'm now having an MPFL reconstruction in a few weeks. This type of surgery is not normally recommended for first time dislocations as physical therapy and aggressive rehab is tried first.

My advice to you would be to try to get your ROM back as soon as you can. I got stuck at about 90 degrees flexion as I kept my leg too straight in an immobilizer brace for a little too long. I ended up having to have MUA to bust up the scar tissue.

Get those quads of yours nice and strong, especially your VMO (I'm assuming it was a lateral dislocation?) I have a pretty good brace but I'd have a chat to your physiotherapist first.

In answer to your question about the length of time dislocated relative to recovery - no relationship there as far as I know. I've got a fair amount of bone bruising that still hasn't subsided - takes a few months from what I've been told.

Good luck and work hard at physio! Let me know if you have any more questions about my experience that might help.

 :) Karen
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline allyd

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Re: Dislocated patella
« Reply #2 on: March 09, 2012, 01:52:33 PM »
First – dislocations are no fun, so we definitely sympathize with you. I haven’t had to have mine reduced in the ER, so I can’t tell you if there is a relationship between length of time out and recovery.

As mentioned by Karen, you should do all you can to keep motion in your knee. Immobilizing completely is not the best thing for it. Follow your Physio’s advice and only use when absolutely necessary. There are a lot of braces available, and maybe you’d benefit from a hinged brace of some variety, or even just a compression sleeve for added “mental” support. By listening to your Physio and doing the work - You will heal and get stronger each week, but we all heal at different rates.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline sapphireblue

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Re: Dislocated patella
« Reply #3 on: March 12, 2012, 02:03:15 AM »
Thank you for the replies.  I really appreciate it!  My ortho told me to keep the immobilizer brace on for another 4 weeks and stop physio altogether until that time.  Reading your replies makes me question that.  I'm going to rest easy for a week or two and then revisit physio.  I can't imagine being in this immobilizer for so long. I'm already going stir crazy!

Offline lululocket

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Re: Dislocated patella
« Reply #4 on: March 12, 2012, 11:10:07 PM »
Hi there,
So sorry to hear about your dislocation. I have been in the same situation before, although my problems were caused by abnormal anatomy which may not be the same as you. Fear and confusion were the main problems, so find out as much as you can, and try not to worry too much, modern medicine is pretty awesome for fixing things, and the motley crew you find here are usually the ones needing a bit of extra help!
After my worst dislocation I was immobilised for 3 weeks before I started PT. It didn't do any long term damage, but it did set me back somewhat, both in terms of the knee feeling 'sticky', and also muscles wasting away. Even if your OS wants you to stop physio for a while longer (which doesn't sound like the greatest idea in the world, but obviously he has seen your knee and we 'internet people' haven't), it might be worth considering sitting with your leg out, undoing the brace and just using your hands to gently get some bending going a few times a day (passive flexion).

Is there a brace that will allow more movement but still provide support?
The type of brace I'm currently wearing (just had surgery to move my kneecap) is a donjoy brace - it is currently locked straight, but normally will bend to a preset maximum, so that you can gradually allow more and more ROM. I've never had one like this before, but the principle seems sensible I guess. It is quite heavy with all the metal, but then so are the 'cricket pad' ones I've had before (just keeping everything straight).
http://www.donjoy.com/images/products/pdfs/coolirom.pdf
There are also braces with holes for your knee cap, which are much lighter. I'd have a browse on the post op/patellofemoral sections of this site to get an idea of what things look like and work out what you have, as there are LOADS of different braces. http://www.donjoy.com/

How much time should I be spending resting?  I don't want to overdo it and cause further injury. 
I'm doing physiotherapy.  What else should/could I be doing to speed recovery?

The main thing is to learn to listen to your own knee.
Getting the swelling down is important; check with your GP about taking ibuprofen or something similar to reduce inflammation. Ice and elevation are also good. In terms of overdoing it; if you can look at your knee regularly you will see what causes it to swell up more or get hot, and make sure you limit those things; it might be standing for example, because of the height of the limb, or maybe it's actually motion or a little weight bearing that causes more swelling.
You could also investigate taking arnica orally (which is for bruising and I took on my doctor's advice after a dislocation).

Does the length of time my patella was dislocated affect recovery time?  It was left dislocated for over 2 hours in total.  Is this time going to mean longer healing time?
I might be wrong, but I don't think so. The damage will be caused by stretching the ligaments, scratching bones past each other and then slamming them back again. Keeping it out won't particularly impact those things as far as I know. Mine was out for about 3 hours, so I really feel for you here; it's pretty hideous to think about. Extra mental trauma is probably the main difference. And a better story to milk....
2003 RK dislocation
multiple sublaxations (10+), both knees
2007 LK dislocation
03/2010 TTT on RK
03/2012 TTT on LK















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