Kneecap dislocated (Patella luxation)

What is a patella luxation?

The kneecap (patella) is located at the front of the knee and normally slides smoothly into a groove (groove) of the femur. In a patella luxation, the kneecap shoots out of this groove, almost always to the outside of the knee.

This is different from a ‘knee dislocation’ (where the lower leg shifts relative to the upper leg), which is a much more serious and rare injury. In a kneecap luxation, the knee ligaments stretch, causing swelling and pain. Often, the kneecap shoots back into place on its own, but sometimes it needs to be repositioned by a doctor or nurse.

Causes and symptoms

A kneecap dislocated often occurs during sports, for example when you bend and twist the knee at the same time. We often see this in sports with a lot of hooding and twisting movements, such as football or hockey. A direct fall can also be the cause.

The symptoms are often very obvious:

• The kneecap sits as a thick bump on the outside of the knee.
• There is a lot of pain and you cannot lean on the leg.
• The knee quickly thickens due to fluid accumulation in the joint.

Why does a knee dislocate?

Not everyone's kneecap dislocates as easily. There are certain risk factors that increase the likelihood. Teenagers in the growth spurt, especially girls, are more likely to suffer from this injury.

Other contributing factors include:

• The shape of the kneecap or gutter (if it is shallow, the disc slides out more easily).
• The position of the legs (e.g. X-legs).
• Knee ligaments too slack (hyperlaxity).

Diagnosis and examination

If your kneecap has been dislocated, it is important to check that there is no additional damage. This is because sometimes a piece of bone or cartilage breaks off when the kneecap shifts. An X-ray is often taken in hospital to rule this out.

At Physio Fitaal, we use ultrasound diagnosis and examination to get a good view of the soft tissue around the knee, such as the ligaments. This allows us to see exactly what is going on and adjust our treatment plan accordingly.

Recovering from a dislocated kneecap

Recovery proceeds in several stages. In most cases, surgery is not immediately necessary and the knee can recover with the right guidance.

Phase 1: The acute phase (Week 0-2)

Immediately after the injury (or after the kneecap is reset), rest is essential. You will often be fitted with a splint, plaster cast or solid brace to give the knee rest. This allows the stretched ligaments to recover.

• Cool the knee to reduce pain and swelling.
• Put the leg up as you sit.
• Load the leg as little as possible; use crutches if necessary.

Phase 2: Mobilisation and light exercises (Weeks 2-6)

After about 1-2 weeks, the plaster cast or splint is often replaced by a special knee brace. This brace provides support, but allows you to carefully start bending and loading the knee again. In this phase, you often start with gentle exercises under the supervision of the physiotherapist. These include tightening the thigh muscles (quadriceps) and carefully lifting the stretched leg.

Phase 3: Build up to load (After 6 weeks)

After about six weeks, there is often a check-up in hospital and the brace may usually be tapered off. The focus now shifts to strengthening the muscles around the knee and hip. Strong muscles, especially the thigh muscles, are essential to prevent the kneecap from dislocating again.

Treatment at Fysio Fitaal

At Fysio Fitaal, we guide you intensively during your rehabilitation. Because a displaced kneecap has a big impact on confidence in your body, we pay a lot of attention to stability and anxiety-free movement.

Our treatment focuses on:

• Mobility: Making sure the knee can bend and stretch smoothly again.
• Strength: Training the quadriceps (front thigh) and glutes specifically.
• Stability: Exercises to improve knee control so you no longer sag.
• Sports-specific: Want to play football or run again? We will tailor a plan to get you safely back to your old level.

Do you have general knee complaints or residual complaints such as the patellofemoral pain syndrome? Even then we can help you.