Patellar Subluxation Treatment

The patella, otherwise known as a kneecap, sits on the top of the knee joint that is connected to the other knee bones and muscles with a network of tendons. The patella itself sits in a layer and can be dislocated from this tendon, which is referred to as a patellar subluxation. Treatment varies depending on the severity diagnosed by your doctor.

Non-Operative Treatment

• An acute dislocation may be put back into place if the patella is unreduced, which means the patella is visible and not hidden within the knee joint. The doctor will flex the hip and apply medial stress as the patient's knee is extended. Once the patella is moved back into place, the knee will need to be immobilized to prevent any side movements so it can heal. If the patella is unreduced, but X rays show a bone fragment or chip, this method cannot be used.

Surgery

• Extreme cases require surgery. Some examples include bone chips located in the joint, ruptured tendons or a reduced patella. For children, arthroscopy is the preferred method to keep surgery as non-invasive as possible. Arthroscopy is a minimally invasive surgical procedure to repair damage to a joint.
  During surgery, any bone fragments are removed to prevent chronic abrasion, tears or locking of the joint. Tendons may be released to reduce pressure on the patella or repaired if they are damaged. Pinning may be required in a small number of cases where lesions on the bone and cartilage are present.

Physical Therapy

• Whether the patellar subluxation requires surgery or not, the patient will require physical therapy. The knee should be kept immobilized as medial movements are slowly introduced. Ice and ibuprofen should be used to reduce swelling and pain. When actual exercises are started, the patient should use a patellar opened brace that stabilizes everything around the patella, which sits exposed by a circle. Quadriceps exercises are done to increase the strength of the muscles supporting the knee. The hamstring and calf muscles are also strengthened through therapy. It can take 2 to 6 months or longer to fully recover from a patellar subluxation.