The kneecap flew out: what to do if the knee pops out of the joint and falls into place, how to choose a joint fixator

The kneecap, or patella, is a rounded bone that protects the joint from injury. It is held by strong connective tissue formations - ligaments, and they keep it in a stable position. If the kneecap is knocked out, this may be accompanied by a sprain or rupture of the ligaments, and at the time of injury the patient feels acute pain. It may then pop back into place on its own, but in most cases it will pop out with subsequent falls or bruises.

Author of the article / Site experts Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.

Causes

There are numerous factors that cause dislocation and loss of the knee joint:

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Limb injury. The integrity of the joint capsule is compromised, and surrounding tissues (muscles, tendons and ligaments) are damaged.
Late consultation with a specialist if a limb is damaged.
Defect of the joint surface.
Incorrectly provided first aid after injury, lack of immobilization or premature termination.
Failure to comply with doctor’s recommendations and limited exercise regimen during the rehabilitation period.

We should not forget about the provoking causes that increase the risk of injury:

deformity of the knee joint,
bowed legs,
high mobility and alignment of the patella,
weak ligaments, hypermobility.

A knocked-out kneecap is a consequence of atrophy or hypotrophy of the medial femoral muscle. The same goes for any muscle imbalance. The patient requires qualified assistance to prevent possible complications. We are talking about chronic instability of joints, rupture of ligaments and deformation of damaged cartilage, bleeding.

Diagnostic methods

Although the position of the patella can be determined visually, additional diagnostic methods will be required. If the cup has moved to the side, this means that its ligaments are also damaged.

The longer this bone remains in the wrong position after the knee has been knocked out, the greater the risk of ligament and tendon rupture.

These changes can be seen on x-rays. If a patient’s knee periodically flies out, but then comes back, the symptom requires a more detailed diagnosis. The joint is examined using ultrasound and MRI; these methods allow you to visualize the condition of soft tissues, ligaments, muscles and tendons. Based on the results of the examination, treatment will be prescribed.

Symptoms

Pathological changes are accompanied by characteristic signs. Doctors recommend going to the hospital immediately if any symptom appears:

the normal position of the kneecap changes, it moves,
severe pain occurs,
it is difficult for the patient to lean on the injured limb,
it is impossible to straighten the leg (when trying to stretch it, severe pain and sensation appear
presence of a foreign body in the joint area),
the tendons are constantly tense (determined by the doctor upon palpation).

A person can correct a dislocation on his own. If the kneecap moves outward, one movement is enough to return it to its place. The phenomenon is accompanied by severe pain, but after the joint returns back, it disappears.

It is important to provide first aid to the patient in a timely manner to prevent swelling and serious consequences. A knocked-out kneecap can trigger degenerative changes in the structure of the bones and cartilage.

How to develop a knee after surgery: methods

Immediately after 12-24 hours after surgery, for 3-7 days, you will be advised to perform a light form of exercise in a lying position. The frequency of repetitions and the daily number of sessions is determined by a specialist.

Carefully lift the problematic leg off the bed, lifting it 20 cm from the surface. The healthy leg is bent at the knee at this time. Hold the position of the raised leg for 5 seconds, then carefully return the limb to its original position.

Work smoothly.

Slightly bend both legs (support on the heels), tense the thigh muscles. On the count of ten, relax.

Arms along the body, torso relaxed.

Perform an isometric contraction of the gluteal muscles while holding the tension for 5-8 seconds.

Do this until you feel a slight burning sensation.

Lying on your back, placing a cushion made of a towel under your foot, apply pressure to it, trying to bend your leg. After 5 seconds, relax. The ligaments of the popliteal zone and the muscle structures of the lower leg will be strained.

The main thing is not the effort, but the smoothness of the increase in load.

Legs lie flat on the bed.
Make movements with your feet towards and away from you, without lifting your heel off the surface. It is useful to alternately spread your legs to the sides, sliding along the sheet. Do it very slowly.

Gentle exercises are gradually supplemented with more complex exercises. Let's give examples of some of them.

Stand against a wall or near a chair to secure yourself.
Slowly raise the affected limb straight forward. Having reached an angle of 45 degrees, hold your straight leg on the weight for 5 seconds, and also smoothly return it to the starting position. Don't forget about the hand rest.

Perform a similar task as the one described above, but only with the foot facing outward.
Holding the back of the chair, move the limb to the side (without jerking!), lifting it a short distance.
Hold for a few seconds and return to IP. Keep your balance.
Lie on your back and place a cushion under your operated knee.
With support on the roller, straighten your leg. Hold the position of the straightened leg for about five seconds, then slowly return to the original position. Smooth execution is the key to avoiding injury.

After 2-3 weeks, they move on to active training, where the following type of classes will already be present:

half squats near a chair (the angle of bending of the knees does not exceed 90 degrees);
Try to rest on the entire area of your foot.
stretching exercises, for example, bending the leg with grabbing the foot with the hand and pulling it towards the buttocks;
If you move your pelvis forward, the stretching effect will increase.
performing resistance tasks using a rehabilitation expander or rubber band;
You can come up with a lot of exercises with a tourniquet.
stepping (front and side) onto the step platform with the body weight transferred to the leg that was operated on and with its further straightening;
Alternate legs while performing this exercise.
exercise on an exercise bike, using a light pedal resistance mode, gradually increasing it to medium, heavy.
This is the best equipment for rehabilitation.
walking on a treadmill, start at a slow pace and walk for 10 minutes, then gradually increase speed and time;
aqua gymnastics and swimming in the pool.
We recommend practicing in the pool for life.

When performing physical tasks, listen to your own feelings: you must control the threshold of acceptable pain, not allowing it to intensify. Overloading is unacceptable! Unoptimized loads will cause painful swelling; how long it lasts depends on the degree of damage caused to vulnerable knee structures. But the saddest thing is that swelling and pain will slow down the recovery process, interfere with the normal development of the joint, and increase the time until your final recovery.

First aid

A prolapsed knee joint cannot be ignored. Even if the knee pops out and snaps back into place, the patient still requires first aid. Doctors recommend taking the following steps immediately after a dislocation to minimize subsequent complications:

Position and immobilize the lower limb as comfortably as possible.
A cold compress should be applied to the damaged area.
If severe pain occurs, give the patient painkillers.

The most important thing to do is to immobilize the leg. As the patella dislocates, the ligaments lengthen. In some situations the pain is mild. This indicates that the ligaments are shortened and relaxed. It is not recommended to adjust the knee joint yourself. Doctors warn that without experience and knowledge there is a risk of compromising the integrity of the ligaments, in which case the patient will require emergency surgical care.

Treatment methods

After an injury, it is necessary to provide first aid to the victim. Setting a joint yourself can be dangerous, but there is an algorithm of actions that need to be performed before the doctor arrives. The patient should remain in a lying or sitting position without attempting to use the injured limb.

First aid is as follows:

the leg should be immobilized in the most comfortable position;
ice or cold compresses are applied to the knee area;
if the pain is too severe, you can take painkillers.

Immobilization of the limb is the most important condition.

When the patella dislocates, its ligaments lengthen. The position of the leg, in which the pain is not felt too sharply, means that the ligaments have shortened a little and relaxed. If you move carelessly or try to set the kneecap yourself, they can completely rupture.

Conservative methods

If the patella is displaced for the first time, and the examination does not reveal any obvious violations of the integrity of the ligaments, the patient is recommended to wear elastic bandages for several weeks. Excessive loads should be avoided, but leaning on your leg when walking is not prohibited.

Treatment will consist of several main points:

use of local anesthetics and anti-inflammatory drugs;
physical therapy to increase the strength and elasticity of muscles and ligaments;
UHF;
physiotherapy to improve blood circulation;
massage from a competent specialist.

Plaster application is also a conservative treatment method. This is necessary if the injury is accompanied by acute pain and partial rupture of the ligament fibers occurs.

The plaster cast is worn for 2-3 weeks, after which it is changed to an elastic bandage.

Surgery

Surgical intervention is necessary only if the integrity of the ligaments or tendons of the muscles was damaged at the time of the injury. Partial rupture of the fibers is treated under plaster, but if the ligament is completely separated, its ends must be connected by suturing. The operation is performed using arthroscopy - through two small punctures near the knee joint. Healing occurs under a cast or tight elastic bandage.

The rehabilitation period after surgery can last up to 6 months.

Diagnostic measures

Additional examination methods allow the doctor to establish an accurate diagnosis. Patients are prescribed diagnostic measures such as x-rays, magnetic resonance imaging (MRI), and arthroscopy.

The listed methods allow you to obtain accurate information about the injured area and identify additional pathological formations.

Magnetic resonance imaging is used in most cases , since the examination results show the condition of the tissues.

Arthroscopy is prescribed to patients if the doctor suspects intra-articular damage. It is important to establish an accurate diagnosis. The doctor, taking into account the test results and the individual characteristics of the person, will select the most effective treatment for the patient.

Therapy

Displacement of the joints can cause serious complications without timely help. Not only the first steps are important, but also the general principles of treatment. If the knee joint pops out, the patient is prescribed conservative therapy.

In difficult situations, an operation is performed, and after it it is allowed to use folk remedies along with physiotherapeutic procedures and exercise therapy.

Conservative treatment

An orthopedist or traumatologist deals with knee dislocations. It is not recommended to adjust the cup yourself, as it can damage the joints, ligaments and tendons. After the manipulations, the patient’s leg is fixed and medications are prescribed.

Non-steroidal anti-inflammatory drugs reduce pain and eliminate the inflammatory process, alleviating the human condition (“Ibuprofen”, “Paracetamol”, “Naftalgin”).

Medicines are prescribed by a doctor, since many of them have a list of contraindications and can cause side effects. On the 3rd day after the injury, the doctor prescribes warming ointments (“Apizartron”, “Viprosal”, “Capsicam”). These medications should not be used immediately after an injury, because heat will increase swelling and intensify the inflammatory process.

Surgical intervention

The operation is prescribed by the doctor after a thorough examination, based on the results obtained. The surgeon performs the procedure immediately after the injury or after some time. If the knee joint pops out, surgery is indicated in the following situations :

when ligaments are torn,
if joint displacement is not observed for the first time,
to remove other parts of the knee that have fallen into the joint cavity,
if there is a tear, rupture or torsion of the meniscus,
with an abnormal structure of the knee, as a result of which its mobility is impaired.

Surgery can be performed invasively or openly. Damaged or stretched ligaments are sutured. The same applies to the menisci; sometimes their removal is required.

After the operation, the patient is given a plaster cast for 1.5 months to completely immobilize the limb. The patient will have a rehabilitation period with the performance of certain exercises, which will be selected by a physiotherapist, taking into account the condition of the person and the joint.

Therapeutic exercises help strengthen ligaments and prevent repeated pathological changes and dislocation. After the exercises, the functions of the knee joint are restored.

Doctors use radical methods to treat old injuries. In some situations, the kneecap or damaged cartilage is removed.

After surgery, the patient must constantly wear a knee joint restraint (an orthosis is a special medical device that reduces the load on the damaged area).

Physiotherapy and exercise therapy

To improve biochemical processes and microcirculation in the joint, patients should attend physiotherapeutic procedures. Treatment sessions are prescribed after surgery. The procedures also promote rapid healing of tissue in the damaged area.

Patients are recommended to attend the following treatment:

electrophoresis,
mud and paraffin baths,
electromyostimulation,
laser treatment,
magnetic therapy,
ultrasound,
inductothermy,
massage treatments,
cryotherapy.

Physiotherapy has a positive effect on the injured leg:

Restores motor functions of the limb.
Stimulates the production of joint fluid.
Reduces signs of inflammation and swelling.
Restores blood circulation.
Improves metabolism in damaged tissues.

Physical therapy can be started during the rehabilitation period after severe injuries. Classes begin with light exercises, which the doctor will select , taking into account the patient’s condition.

At the first stage of recovery, patients are recommended to engage in passive exercise. After some time, it is allowed to move on to active activities if the patient’s condition has not worsened. Exercise therapy helps reduce pain after injury.

ethnoscience

Recipes from witch doctors and healers can also be used for treatment if the knee joint pops out. Therapy is carried out during the rehabilitation period and after consultation with a doctor. The components of traditional medicine used can provoke an allergic reaction. It is important to consider contraindications. Effective recipes:

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Tansy compress. Pour boiling water (1 tbsp) over the flowers of the plant (3 tablespoons) and leave for 1 hour. Strain and apply to the damaged joint.
Milk compress. A gauze bandage is applied to the site of the dislocation. It should first be moistened with hot milk.
Compress based on common agrimony. Pour boiling water (2 tbsp) over the herb (3 tbsp), heat for 20 minutes on the fire. Cool, strain and apply to the sore joint.
Fresh wormwood leaves. The plant is crushed, the resulting mixture is applied to the damaged area.
Onions with added sugar. The main component is cleaned, washed and ground into a paste. Add a small amount of sugar. The resulting mixture is spread on gauze and the joint is bandaged.

To treat a knee, use a mixture of garlic (2 heads) with apple cider vinegar (100 g). The components are combined and left to infuse for 5-6 days. When the medicine is ready, it should be rubbed into the damaged joint.

It is important to carry out treatment under the supervision of a specialized doctor. The specialist will tell you what to do if the kneecap flies out, and how to prevent serious complications after a lower limb injury.

Knee dislocation: symptoms and types

Dislocation is determined by a number of general symptoms, independent of location:

Pain. At the moment of injury, sharp and intense pain appears; its further manifestations depend on the extent of the injury, the type of dislocation, the cause and severity of the injury, and the time of first aid. When moving, the pain in the knee intensifies.
Forced pose. The patient takes a position where the leg does not hurt, and tries not to change it.
Deformed articular area. The appearance of changes in the knee is influenced by the type of injury, the severity of the dislocation, and its type.
Joint dysfunction – limitation of movements.
Swelling in the knee area caused by blood in the joint cavity or synovitis.

Shin injury

A sprained ankle has its own symptoms. Injury to the lateral and cruciate ligaments (with subluxation, only the cruciate ligament is damaged), displacement of the tibia to the sides or back and forth leads to extensive hemorrhage into the articular cavity, and often damage to the neurovascular bundles, which causes numbness of the lower leg and foot with absence of pulse in vessels of the foot, pale, bluish skin. Paralysis may develop in the lower leg area, which requires immediate reduction of the joint before irreversible changes occur. Clinically, a dislocation of the leg is determined by the presence of sharp, intense pain and the inability to move the leg. The injured limb is straightened, the knee is deformed. The tibia protrudes forward in an anterior dislocation, and backward in a posterior dislocation.

Calyx injury

Dislocation of the kneecap can be lateral, torsion, complete or incomplete (subluxation). More often, lateral subluxation of the cup is diagnosed, which appears with weak knee ligaments and X-shaped deformed legs.

CT.

Symptomatically, a dislocation of the patella, if it is not acute, manifests itself only as a “failure” in the joint when the patient bends the leg in the knee area. Acute injury to the patella is manifested by pain, limitation of movement, and swelling may occur due to hemarthrosis.

How to recognize a dislocation immediately and not confuse it with a fracture, see this video:

Habitual dislocation of the knee joint

Appears as a result of frequent jumping of the kneecap from the physiological channel of sliding, and manifests itself with its own characteristics. Usually this is mild pain and discomfort, and arthrosis develops over time. This pathology often affects children and young women. The first episode may be accompanied by acute pain, weakening of the legs at the knees, and the inability to straighten the leg independently. In the future, patients no longer seek medical help, but adjust the cup themselves.

The causes of habitual dislocation in the knee joint are:

increased elasticity of ligaments;
patella located above the normal anatomical position;
damaged and non-union of the suspensory ligament of the patella;
flattened sliding paths of the femur bone, where the groove that guides the patella is located.

Knee subluxation

Subluxation of the knee joint forms in the kneecap and is caused by overextension or rupture of the patellar ligaments, weak femoral muscles, and anatomical abnormalities in the lower extremities. This leads to instability of the kneecap and its subluxation even with minor injuries.

Symptoms: pain and a typical crunch in the knee when moving, a feeling of instability in the kneecap. Over time, knee subluxation leads to arthrosis and synovitis.

“Doctors are hiding the truth!”

Even “advanced” joint problems can be cured at home! Just remember to apply this once a day...

Congenital dislocation

Congenital dislocation of the knee is a severe and rare pathology that develops in the fetus in the second trimester and is diagnosed more often in girls. It must be treated surgically.

Patella dislocation

This injury is often diagnosed in people involved in sports and high physical activity. Divided into three types:

Acute dislocation.
Old dislocation.
Habitual luxation of the patella.

Dislocation of the patella at the first manifestation is characterized by severe and sharp pain, with slight swelling of the knee joint, and stepwise deformation of the knee. Pain occurs with any attempt to move. The kneecap is displaced to the outside; over time, it can return to its physiological position, which does not negate the need to consult a doctor.

Prevention

You can prevent dislocation of the knee joint by simply remembering the recommendations of doctors and sticking to a healthy lifestyle. If a lower limb is bruised, it is important to correctly provide first aid to the person and immediately go to the hospital.

Only a specialized doctor can straighten the knee and prescribe further treatment. The specialist will tell you why the knee joint falls out and how to alleviate the patient’s condition before the ambulance arrives.

It is recommended to continue exercises and training after the acute period has stopped, but without fanaticism. If the muscles of the thigh and lower leg are in normal tone, the knee will be restored much faster.

Doctors also recommend avoiding situations that increase the risk of injury. We are talking about riding a motorcycle and horses, skiing, jumping from great heights.

How is it diagnosed?

Diagnosis of knee dislocation and its type is carried out using a set of measures:

History taking, visual examination, palpation.
X-ray to determine the nature of the displacement and exclude bone damage, differential diagnosis of knee dislocation from meniscus damage.
MRI or computed tomogram.
Arteriogram – performed for symptoms of damage to the neurovascular bundle to clarify the presence of vascular injury.
Ultrasound of the joint, Doppler sonography - to analyze blood flow.
Neurological test of skin sensitivity.
Checking the presence of a peripheral pulse to determine vascular patency.

Diagnosis should begin as quickly as possible, as soon as the first signs of a knee joint injury appear, because the complex of therapeutic measures and the timing of knee recovery depend on this.