A dislocated patella or kneecap occurs when the kneecap moves out of place, tearing the medial patellofemoral ligament. This ligament normally keeps the patella in its anatomical position. This injury causes pain and discomfort. Patients may feel like the kneecap has slipped, and the knee may give way under the weight of the body. The knee may swell and change shape, appearing deformed as a result of the injury.
If your kneecap is dislocated, Dr Marais will perform a thorough knee examination in order to confirm the diagnosis. He will check the range of motion, the extent of your sensitivity and assess any swelling or other physical symptoms. He may perform imaging tests such as an x-ray or MRI scan to view the full extent of the damage.
In some cases, a dislocated kneecap may be treated with a procedure known as a reduction. During the procedure, the kneecap is gently moved back into place soon after the injury occurs. Often, Dr Marais may recommend a brace to support and stabilise the knee after the procedure. In many cases, physical therapy is also recommended, which can be very helpful in regaining normal mobility.
In some cases, especially if a dislocation recurs, surgery may be required. If surgery is necessary, Dr Marais will perform the procedure as a combination of arthrosopic and open surgery, which is a much less invasive technique than traditional open surgery, and typically allows for a quicker recovery time and less pain post-surgery. The open surgery is done using three 2 cm incisions. Dr Marais will perform the surgery by first doing an arthroscopic examination of the knee joint and removing any damage articular cartilage. Then one of the hamstring tendons is harvested in order to reconstruct the medial patellofemoral ligament. This is done by attaching the hamstring tendon to the patella on the insertion area of the medial patellofemoral ligament as well as on the femur to the insertion area of the medial patellofemoral ligament.
After the surgery, Dr Marais will advise you on the best rehabilitation plan, which may include physical therapy, and some lifestyle changes. Normally the patient is advised to use crutches for at least six weeks postoperatively.