Patellar Dislocation: Recovery, Rehabilitation, and Prevention Tips

Q: Patellar Dislocation: Recovery, Rehabilitation, and Prevention Tips

Hello： On November 7, I experienced a dislocation of the left patella and underwent a manual reduction procedure, which was two weeks ago. <br>1. <br>I will wait for the swelling to subside before starting rehabilitation for quadriceps strength. <br>2. <br>I still need to wear a

Patellar dislocation

On November 7th, I bumped into a chair, resulting in a dislocated patella in my left leg.
My teacher immediately took me to the emergency department at Cheng Hsin Hospital, where they performed a manual reduction and applied a splint (only a splint board).
The next day, an orthopedic doctor at Mackay Memorial Hospital removed the splint and drained the blood accumulation from my knee.
I have not returned for a follow-up appointment yet because the last time they drained the knee, it was very painful.
However, I went to a lab for an X-ray to confirm that the patella was not dislocated or misaligned again.
I have a few questions:
1.
I often feel weakness in my leg.
What rehabilitation exercises should I do to prevent further weakness?
2.
I have sensitive skin, and after wearing a knee brace, I started developing a rash.
How should I manage this?
3.
Is it likely that I will experience recurrent patellar dislocations, and how can I prevent this?
4.
How long will it take before I can resume activities, such as karate?
5.
Will I need to wear a knee brace for all activities in the future, or can I use a patellar strap instead?
6.
Are there any specific precautions I should be aware of?

Xiao Tian Shi, 10~19 year old female. Ask Date: 2018/11/22

Dr. Li Yongheng reply Orthopedics

Hello: On November 7, I experienced a dislocation of the left patella and underwent a manual reduction procedure, which was two weeks ago.
1.
I will wait for the swelling to subside before starting rehabilitation for quadriceps strength.
2.
I still need to wear a knee brace, which can be worn over long pants.
3.
The knee brace should be worn for 6 weeks, and excessive knee flexion should be avoided to prevent recurrent patellar dislocation.
4.
It will take at least 3 months before I can engage in karate activities.
5.
If there have been no dislocations or subluxations for 3-6 months, I can stop wearing the knee brace.
6.
If necessary (for example, if there is persistent effusion, weakness, or pain), an MRI should be performed to rule out other intra-articular knee pathologies.

Reply Date: 2018/11/22

More Info

Patellar dislocation is a common injury, especially among athletes and active individuals. It occurs when the kneecap (patella) slips out of its normal position, often due to trauma or a sudden change in direction. Your situation, where you experienced a dislocation after hitting a chair, is not uncommon. Here’s a comprehensive overview of recovery, rehabilitation, and prevention tips based on your questions and the medical context.

1. Rehabilitation for Strengthening
After a patellar dislocation, it’s essential to focus on rehabilitation to regain strength and stability in your knee. Here are some exercises that can help:
- Quadriceps Strengthening: Exercises like straight leg raises and wall sits can help strengthen the quadriceps, which play a crucial role in stabilizing the knee.

- Hamstring Strengthening: Incorporate hamstring curls to ensure balanced muscle strength around the knee.

- Balance Exercises: Use a balance board or perform single-leg stands to improve proprioception and stability.

- Range of Motion Exercises: Gentle stretching and range of motion exercises will help prevent stiffness and maintain flexibility.

It’s advisable to work with a physical therapist who can tailor a rehabilitation program specific to your needs and monitor your progress.

2. Skin Irritation from Knee Braces
If you are experiencing skin irritation or rashes from wearing a knee brace, consider the following:
- Skin Care: Keep the skin clean and dry. Use hypoallergenic products to minimize irritation.

- Alternative Bracing: If the current brace is causing issues, consult your doctor or therapist about switching to a different type of brace that may be more comfortable.

- Padding: Adding soft padding between your skin and the brace can help reduce friction and irritation.

3. Preventing Recurrent Dislocation
To avoid recurrent patellar dislocation, consider these preventive measures:
- Strength Training: Focus on strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and hip muscles.

- Flexibility Training: Regular stretching can help maintain flexibility in the muscles and tendons around the knee.

- Proper Footwear: Wearing supportive shoes can help maintain proper alignment and reduce the risk of dislocation.

- Avoid High-Risk Activities: Until you have fully rehabilitated, avoid activities that put excessive stress on the knee, such as jumping or pivoting.

4. Timeline for Returning to Sports
The timeline for returning to activities like karate can vary based on the severity of the injury and your rehabilitation progress. Generally, you can expect:
- Initial Recovery: 4-6 weeks for basic healing and to regain range of motion.

- Strengthening Phase: 6-12 weeks for building strength and stability.

- Return to Sports: Most individuals can return to sports within 3-6 months, but this can vary. Always consult with your healthcare provider before resuming activities.

5. Use of Knee Braces
Using a knee brace during sports can provide additional support, especially after a dislocation. However, whether to use a brace or a patellar strap depends on your comfort and the advice of your healthcare provider. A patellar strap can help with patellar tracking issues, while a knee brace offers more overall support.

6. Additional Considerations
- Listen to Your Body: Pay attention to any pain or discomfort during activities. If you experience significant pain, it’s essential to rest and consult your doctor.

- Follow-Up Appointments: Regular follow-ups with your orthopedic specialist are crucial to monitor your recovery and make necessary adjustments to your rehabilitation program.

- Gradual Return to Activity: When you start exercising again, do so gradually to avoid overloading the knee.

In conclusion, recovery from a patellar dislocation involves a combination of rehabilitation exercises, proper care of your skin, and preventive strategies to avoid future dislocations. Always consult with your healthcare provider or a physical therapist to create a personalized plan that addresses your specific needs and concerns.

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