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Author Topic: Dislocated Patella, now what?  (Read 1201 times)

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Offline Jackomacko

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Dislocated Patella, now what?
« on: July 09, 2014, 03:21:31 AM »
About 10 weeks ago i dislocated my left patella playing rugby. I was standing still when the ball got passed to me and the knee cap popped out laterally (outside). It got popped back in within 10 mins by the physio at the game before an ambulance arrived 30 minutes later. I was in hospital for a couple of hours where they x-rayed my kneecap. It looked like there may be a possible bone fragment loose. After being released I was in a knee brace for a week before being on crutches for two weeks. I had an MRI a week after I dislocated it and I had tore my patella-femoral of the bone. (I believe this is the medial ligament?) I had a grade II strain on my Medial Ligament on the same knee 6 months earlier. Is this a reason why it dislocated? I saw a knee surgeon with the results and he said there was a 19% chance it will re-dislocate so surgery is not definitely needed. I have now finished physio and I can walk fine on flat surfaces and basically run. My leg get's tired easily and I have lost a lot of muscle but I am rebuilding. I can nearly bend my knee to 180 degrees and can fully straighten it. I was told not to do any sport til my next appointment with the surgeon which is 1 week away. I played soccer yesterday (no contact, just kicking) and I could run and kick fine but my knee felt super tight and I felt instincted to stay away from using it. When I go upstairs or down my knee clicks and feels like it is wearing away on the flesh around the knee.

Should I be pushing it harder?
Will I need to tape it when I play games again?
The knee joint looks very boney and not normal?
Still minor swelling is this ok?
Occasionally hurts going up or down stairs, is this normal?
Knee clicks ALOT! What should I do?
What are the chances I will redo it? (I was told 19%)
Should I play rugby again? (Next game is 10 days away an there is only 4 games remaining)

Offline mattyj

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Re: Dislocated Patella, now what?
« Reply #1 on: July 13, 2014, 12:19:45 AM »
Hi mate,

I have dislocated my kneecap twice so I understand your pain/frustration. My first dislocation was on a trampoline - I was trying to be clever and did a flip, but when I landed my right kneecap dislocated to the outside (laterally like yours). Luckily the kneecap went straight back in when I straightened my leg. I had ongoing problems with my knee for years as a small fragment of bone had broken off as well as a chunk of cartilage which became lodged in the joint. A couple of operations later and I could fully straighten my leg again, but it took quite some time to feel and look "normal" again.

My recent dislocation was on a basketball court and pretty much the same thing happened. I was cutting hard to the basket and when I planted my foot I felt the kneecap go and I instantly hit the floor. It has been 3 weeks since the injury and generally the pain is Ok but there is a massive amount of fluid still on the knee which is limiting my range of motion and is not allowing my quad to fully engage - i.e. cannot do a straight leg raise. My surgeon aspirated the knee joint (drained the fluid) to help with comfort but due to the damage the fluid has come back. I'm doing physio and various basic strengthening exercises to try and help rebuild the muscle (amazing how fast it wastes away). I'm also doing 20-30 minutes of [pain free] cycling every 2nd day to help keep the joint from becoming stiff and to try and disperse some of the fluid. Icing a couple of times a day is also helpful.

Anyway, to try and answer your questions (from my experience):

Should I be pushing it harder?
NO - push it harder and you risk dislocating it again. The ligaments in your knee will have all been severely stretched when your patella went out. You need to work on building the muscles further - particularly the inside quad which helps to hold the kneecap in place.

Will I need to tape it when I play games again?
I would definitely recommend taping it to ensure the kneecap is tracking correctly or to wear a suitable brace with patella support.

The knee joint looks very boney and not normal?
It will probably look messed up for a while (certainly swollen although not sure of "boney") - really only your doc/surgeon can answer this.

Still minor swelling is this ok?
Very normal - could take months for the fluid to fully disperse.

Occasionally hurts going up or down stairs, is this normal?
Yes. Walking up and down stairs puts tremendous pressure on the knee joint - especially going down stairs (the force to the knee joint is equivalent to something like 3.5 times body weight).

Knee clicks ALOT! What should I do?
Probably just fluid "bubbles" popping within the joint which in itself if not damaging anything. Either that or you might have a piece of cartilage grinding in there. But as you still have swelling/fluid on the knee it is probably the former. Over time as the fluid decreases this should settle down.

What are the chances I will redo it? (I was told 19%)
I would say this is an optimistic percentage; it's probably closer to 30-40%. The chances are definitely higher now that you've done it once, so you can't play like you've never done it before - you'll need to be mindful of the risk of re-injury. Good strengthening exercises and bracing will certainly help minimise the risk.

Should I play rugby again? (Next game is 10 days away an there is only 4 games remaining)
Yes, but I'd leave it until next season if I were you. Your knee has been through a massive amount of trauma and if you're still getting pain doing stairs then you're not ready. Give your knee a well-deserved rest and use the off-season to strengthen it so that you can be 100% for next season. The last thing you want to do is re-dislocate it because when you do, recovery is generally significantly longer.

Hope this helps and all the best.

Matt















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