A popped kneecap (patella) or a dislocated kneecap is known as a patellar dislocation. The kneecap jumps out of its sliding bearing and mostly shifts outward. It is one of the most common injuries to the knee joint and mainly affects young athletic people. There are two types of patellar dislocation, which are differentiated according to their cause. On the one hand, the kneecap can pop out as a result of an accident-related trauma; it mostly affects young people. On the other hand, the kneecap dislocation can occur without a previous event due to the nature of the condition. In the following, the symptoms, the causes, the diagnosis and the forms of therapy for a cracked kneecap are explained.
contents
- Definition of patellar luxation
- Popped Kneecap Symptoms
- Risk factors
- diagnosis
- Patellar Dislocation – Treatment
- Naturopathy and holistic medicine
Definition of patellar luxation
A popped kneecap (patellar dislocation) describes an injury to the knee joint in which the kneecap jumps out of its sliding bearing and mostly shifts outward. It is not uncommon for the inner ligament of the knee to tear or tear.
If the kneecap has jumped out, this causes massive pain. (Image: underdogstudios / fotolia.com)
Popped Kneecap Symptoms
The kneecap is a flat, V-shaped and free-running bone in front of the knee joint, which protects it and on the one hand reduces the friction of the four-headed thigh muscle and on the other hand increases its leverage, so that the maximum extension of the knee is made possible. The kneecap is connected to the knee joint capsule by tendons, ligaments and muscles. When the knee joint moves, it slides up and down in a normally precisely fitting slide bearing on the thigh bone (femur). Due to the high forces that occur in the kneecap joint and the joint guidance stabilized only by tendons, ligaments and muscles, the kneecap can pop out for various reasons.
A patellar dislocation is very painful, with knee pain mostly below the knee and on the inside of the kneecap, and immediately recognizable by a typical deformation of the knee. In addition, severe swelling of the knee joint due to joint effusion can occur if there is bleeding from injuries to the ligaments. As a result, there is usually a restriction in movement of the knee. In some cases, small pieces of cartilage or pieces of bone break out due to the patellar dislocation, which become trapped in the joint and can later lead to damage to the cartilage and osteoarthritis in the knee.
Above all, athletes are affected by a trauma-related dislocation of the kneecap, for example, if the affected person is kicked strongly in the knee with a stretched leg and little or no tense thigh muscles. As a result, soccer players are more likely to suffer from patellar luxation. Sometimes impact accidents can also cause the kneecap to pop out.
If the kneecap pops out without a previous accident, the cause is usually a constitutional one. This can be the case, for example, if the plain bearing, in whose “track” the kneecap normally runs, is too flat. A malformed kneecap (patella dysplasia) itself or a high patella, which is often due to an accident, are also possible. Other constitutional causes of kneecap dislocations can include the knock knees (genu valgum), a displacement of the kneecap to the opposite side and a general weakness of the connective tissue .
Risk factors
The risk factors for the kneecap popping out relate primarily to the possible genetic causes. Since women are more often affected than men, the female gender is one of the risk factors for patellar dislocations. A general weakness of the connective tissue, misalignment of the axis as it occurs with knock knees, malformations of the kneecap or its plain bearing, disturbances or weaknesses of the thigh extensor muscles as well as accidental or congenital elevation of the kneecap are also included. In addition, sports like soccer carry an increased risk of knee injuries.
diagnosis
If a kneecap jumps out of its plain bearing, it usually moves outwards. This can be seen from a visual diagnosis due to the typical deformation of the knee. The kneecap often repositions itself spontaneously so that manipulation is no longer necessary. Sometimes a medical history is necessary if, for example, no accident or trauma preceded the patellar dislocation. It may be necessary to take measures to prevent the kneecap from popping out again.
After the kneecap has returned to its original position, either by itself or through manipulation, joint effusion is often visible and palpable. The areas on the inside of the kneecap and on the outer edge of the sliding channel on the thigh are usually pressure-sensitive and painful. In a so-called apprehension test, the doctor pushes the kneecap slightly outwards to provoke a renewed patellar dislocation and thus find out whether the patient’s kneecap had popped out before. If this is the case, the patient defends himself against the pressure because he already knows the feeling, or the knee plate can be moved beyond the slide bearing.
Further examinations can be carried out using x-rays, magnetic resonance tomography (magnetic resonance imaging, MRT) or arthroscopy (arthroscopy). With the latter, small pieces of joint or cartilage can be removed and joint irrigation can be performed at the same time.
Patellar Dislocation – Treatment
Patellar luxation should be treated as early as possible to avoid consequential damage. In most cases, the kneecap will spring back to its original position on its own. However, if the patellar dislocation persists, it must be moved back into the sliding bearing by manipulation by a doctor. Similar to a shoulder dislocation, the risk of a new patellar dislocation increases with every further dislocation of the kneecap. Although there is no causal conservative form of therapy, appropriate muscle training and the wearing of certain orthoses can reduce the risk of further incidents of this type.
If a joint effusion occurs, a puncture may also be necessary, which not only drains the blood but also helps relieve pressure and relieve pain.
However, if the kneecap pops out again or if there is cartilage or bone damage, surgery may be necessary. Different procedures can be used depending on the cause and type of complaint. Often a capsule tightening or patella restraint is carried out so that the path of the kneecap is predetermined and stabilized during movements.
Naturopathy and holistic medicine
If the kneecap pops out once or more often, a visit to the osteopath can be useful and provide information about the cause, which from the osteopathic perspective can affect all structures that have an influence on the statics of the body. In this way, all factors are examined and, if necessary, treated that can lead to tension on or around the kneecap. One example is the iliotibial band, a tendon that runs from the outer articular gnar of the tibia, where it connects to the lateral retaining ligament of the kneecap, and continues on the thigh. The so-called Chapman points, treatment points that correspond to the intestine, lie on the tract. Since the same nerves also supply parts of the intestine here, interactions are assumed in osteopathy
