Integrated & Community Services - Patella Dislocation in children

What is Patella dislocation?

• The kneecap (patella) is a small, round bone at the front of your knee. It moves up and down in a groove between the thigh bone (femur) and the shin bone (tibia) when you bend or straighten your knee
• If you hurt or twist your knee, the kneecap can slide out of this groove. This is called a subluxation (partial dislocation) or dislocation (full dislocation)
• Sometimes, the kneecap goes back into place by itself. Other times, a doctor needs to help. Dislocations can be painful, cause swelling, and make it hard to move your knee
   

Immediately after your injury

• Once the kneecap is back in place, you might need an X-ray to make sure the bones are in the right place and that there’s no other damage
• If it’s your first dislocation, you might need a brace to keep the knee still for up to six weeks. You can take it off to clean the area, but it must be worn at all times
• To reduce swelling, keep your leg raised when sitting and use an ice pack on your knee for 10-15 minutes every few hours
• You may be given crutches for a short time. Walk normally to help your knee heal and keep your muscle strong
• If this isn’t the first time the patella has dislocated, you might not need a brace or cast

Physiotherapy exercises

After a dislocation, you will see a physiotherapist. But it’s important to start exercises right away to make your knee stronger.

Focus on these muscles:

• Vastus medialis oblique (VMO): This muscle is on the inside of the thigh and helps keep your kneecap in place
• Gluteal and core muscles: These muscles help stabilise and control your leg

Ankle pumps

• Lying or sitting, pump ankles towards you and away from you
• You can do this both feet together or alternately. Complete 20 pumps, 3 times a day

VMO contraction

• In lying or sitting, squeeze your thigh muscle, pushing your knee down into the bed and try to get your heel to lift
• Your kneecap should lift slightly, and your thigh muscle should tense
• Hold for 5 seconds, repeat 10 times, 3 times a day, each leg

VMO Straight leg raise

• Lie down or sit with your foot turned out to the side
• Push your knee down and straighten it
• Lift your leg so that your calf is off the bed
• Hold for 5 seconds, repeat 10 times, 3 times a day, each leg

Gluteal muscles:

• It’s important to make your bottom muscles strong because they help keep your knee stable
• When you’re standing, sitting, or lying down, practice squeezing your bottom.
• Hold for 5 seconds, repeat 10 times, 3 times a day
   

Long term outcome

• Most patella dislocations heal well in the long term
• Doing your physiotherapy exercises helps make your muscles stronger and keeps the kneecap in place. This lowers the chance of it dislocating again
• Sometimes, the patella may dislocate again. If it does, restart your physiotherapy exercises as soon as possible
• You may need to see a specialist (paediatric orthopaedic) to decide if surgery is needed. Even if surgery is needed, keep doing your exercises to build strength and help your knee heal

Contact Details

For further information and advice please, telephone Bury Community Paediatric Physiotherapy Team on 0161 206 0657.