Kneecap Dislocation
 

Anyone have this or know much about it. My kneecaps (both of them) dislocate occassionally and it is easily the most painful thing ever. I have mentioned it to doctors and they seem to brush it off. Im sure if I saw a specialist they would be more helpful but have yet to do so. I looked online and found limited info.

Re: Kneecap Dislocation
 

I've done this, and can confirm that it indeed is quite painful.

In my case, I had a stretched MCL ligament, and a slightly stretched ACL. So, I had medial and anterior instability of my right knee. Playing baseball, I always had a strong weight transfer, pushing off my right leg as I swung a bat.

Well, one cold, rainy day - no warm-up, muddy ground, low pitch, and me swinging for the fences, all added up to my right patella dislocating laterally.

I damaged the articular cartilage, and my knee now grinds with bending and straightening (I sound like a bowl of rice krispies when I climb stairs). Doesn't hurt ... yet.

Do your kneecaps actually dislocate? I doubt most docs would brush it off so simply. Mine was truly dislocated, it took another person to straighten the knee so the kneecap could slide back in place. (I was laying supine on the ground with my knee bent, unable to move)

Re: Kneecap Dislocation
 

Yes they actually dislocate. The first time it happened I was only 9 (mine also happened playing baseball) and I was taken to the ER because they thought I broke my leg. At some point during the 6 hour wait in the ER it popped back in and when they looked at it they said it was just a bad sprain.

Now when it happens I just pop it back in myself. Sometimes it goes right back in, other times it may take 20 minutes. Usually after it happens it swells some and is sore for a day or two. Since then Ive mentioned it to doctors but they never seem to think much of it.

Id say between both knees this has probably happened 12-15 times.

Re: Kneecap Dislocation
 

Well, I guess you should see someone about rehabilitation. You want to get rid of any muscle imbalances, particularly between the medial and lateral structures of the knee. Typically, the medial knee stabilizers (especially the VMO muscle or "teardrop") is weak or atrophied/inhibited, and the lateral structures are tight. Sometimes the connective tissues on the lateral side of the knee are very tight, effectively pulling the kneecap laterally.

Again, my knee has never really been the same since the one injury. Yes, it was a little unstable, but I basically scraped my cartilage when the kneecap popped out, and/or when it slid back in place.

Re: Kneecap Dislocation
 

That sounds terrible.
Definitely go to an orthopaedist. The doc will test your joint stability and maybe recommend an MRI. If the doc sees something you'll probably get PT and a knee brace proscribed.

Re: Kneecap Dislocation
 

See a specialist. Eventually you are likely to do some damage and need surgery, and will develop arthritis later in life. A physical therapist will give you a stretch routine that will help prevent them from dislocating again.

My left knee used to dislocate at least once a year and it hurt like hell. In the worst case it resulted in major surgery and 6 months of crutches/rehab. I've been on crutches a bunch of times. Streches make a big difference, but my knee is so bad now I had to just give up on a lot of activities I used to love.

Re: Kneecap Dislocation
 

I was trying to find out if there were some stretches or something I could do to help. I do plan to eventually see a specialist just havent had the time or money. I guess its time to just go.

Re: Kneecap Dislocation
 

i read that this happened to someone playing the bowling game on their wii.

Re: Kneecap Dislocation
 

[ QUOTE ]
Streches make a big difference, but my knee is so bad now I had to just give up on a lot of activities I used to love.

[/ QUOTE ]

I hate to say it, but I'd probably faint if I had to swing a bat again. I still don't trust that particular activity.(swinging a bat is how I initially sprained my knee)

Re: Kneecap Dislocation
 

describe your procedure for relocating it

i presume it is dislocated laterally rather than medially

Re: Kneecap Dislocation
 

[ QUOTE ]
Anyone have this or know much about it. My kneecaps (both of them) dislocate occassionally and it is easily the most painful thing ever. I have mentioned it to doctors and they seem to brush it off. Im sure if I saw a specialist they would be more helpful but have yet to do so. I looked online and found limited info.

[/ QUOTE ]

I had this problem in high school (one of my kneecaps would be turned slightly and hurt like hell until I could straighten it). I used to do Taekwondo and Mogul Skiing a lot, so my knees got destroyed pretty easily. When I was at a chiropractor, she pushed it back into place (it was always slightly out of line), and the problem went away. I only had it happen once since, and I pushed it back on my own and it went away.

Re: Kneecap Dislocation
 

[ QUOTE ]
describe your procedure for relocating it

i presume it is dislocated laterally rather than medially

[/ QUOTE ]

usually my knee is in a semi bent position when it happens. I just grab my knee cap with both hands and very slowly try to straighten my leg whilst gently guiding my kneecap back to its "hole". Straightening it hurts like a sombitch so i can just move it a little at a time. Sometimes it pops right back in. Sometimes it doesnt even get all the way out, I can feel it going but then it just goes right back. It has taken me 40 minutes before to get it back in though.

Re: Kneecap Dislocation
 

next time, make sure you have your hip flexed as much as possible.
i.e. have your thigh as close to your stomach as possible (as though you were in a SEATED position, rather than a STANDING position.)

this will shorten the distance from the quadriceps point of attachemnt at the pelvis, thus looseningn the muscle, and thus making it easier to pop back in.

ICE, ICE, Ice, when it hapens.
and wear an ACE wrap for a few days afterwards

I am not an orthopaedist, but I have stayed at a Holiday Inn Express, before.

I dont know what would be available long term, but I can be certain that they would say strengthening up your quadriceps would be the first place to start to tighten things up (in the hope of taking up the slack).

I know these hurt, as they usually take a bit of sedation and analgesia to reduce.

Aces,
and good luck
doc

Re: Kneecap Dislocation
 

thanks man, I appreciate the tips. I usually ice after it happens, I will start Ace-ing it also. I will def. try flexing my hip. Anything to get that in easier and quicker I will do.

Probably after the first of the year Im gonna try to see a specialist, Im starting to worry im gonna mess my knees up beyond repair and be unable to do anything active.

Re: Kneecap Dislocation
 

Here we go....

1) You DON'T need an MRI, or anything of that nature. The kneecap is NOT part of the knee joint - so you aren't messing up the articular surfaces or the internal ligaments of the knee when your kneecap goes east/west on you.

2) You DO need to see an orthopedist, and most likely you have surgery in your future, although if you're lucky some PT and a good exercise program might get you by. Probably not, though.

3) Patellar dislocations (Kneecaps) are easily my favorite things to fix - you can't screw them up, and patients are very happy. Knee dislocations, OTOH, are pretty much disasters - for you west coasters, the San Jose State football player who lost his leg had a knee dislocation - despite perfect care, somewhere in the neighborhood of 30% of all truely dislocated knees result in amputation - due to vascular injuries that can't be fixed....

MM MD

Re: Kneecap Dislocation
 

thats comforting.

Re: Kneecap Dislocation
 

[ QUOTE ]
the San Jose State football player who lost his leg had a knee dislocation


[/ QUOTE ]
not true

Parry sustained a compound fracture of the tibia and the fibula in his right leg while blocking during a kickoff return against Texas-El Paso on this same field on Oct. 14, 2000. A teammate rolled on the back of Parry's leg after a collision with an opponent.

After a bacterial infection set in and could not be controlled, Parry's leg was amputated about seven inches below the knee nine days after the game.

Re: Kneecap Dislocation
 

Drew,

It sounds like you have a "bucket handle tear" of the Meniscus.

There are two types of meniscal injuries:
1) tearing of the meniscal attachments to tibial plateau and joint capsule
2) crush injury between femoral and tibial condyles

A) bucket handle tear-> longitudinal tear
B) radial tear-> tear running perpindicular to the margins

What happens with the bucket handle tear is a "locking of the knee joint"-> the torn meniscus rolls up and gets trapped in the intercondylar notch, so then there is an inability to completely extend the leg.

It is the toughest knee tear to see in an MRI and the most commonly missed. It is a very common injury with younger patients. They occur from quick change of direction w/ cleats fixed in the ground (soccer), twisting forces at the knee in the shot and discuss events, or you can even tear it skiing by catching a ski tip.

I searched for some pictures to give you a better idea but it is really hard to look at it and get a good understanding of what is going on. Just know that it is a tear and now when your leg goes into knee flexion the torn part get caught in the "bucket handle" and are now stuck, so then when your knee is going into extension it is locked.

The thing with this injury is that it is really only painful when it locks up. And yes it is excruiciating when it locks up...I completely feel for you.

I don't know a whole lost about the procedures to fix it. I do know that it is actually a controversial topic and that there are simple procedures and complex, many believe that there is no need for a complex surgery and that a now conservative approach is best. I am sure you can look this stuff up b/c I don't really know anything about it, I just know how the knee works.

Re: Kneecap Dislocation
 

I was going to type something up, but this does a pretty good job of explaining what I was going to say.

http://orthopedics.about.com/cs/pate...ecapdisloc.htm

I've dislocated one knee 3 times. The first time the kneecap inverted, so it was out of the groove on the outside of my leg and flipped so that the side that should face the knee joint was facing out. This REALLY sucked.

1) Strengthen the quad - this helps keep everything in place - the kneecap and the ligaments.
2) buy braces that look like this for any activity that involves cutting or twisting. http://www.recoverybraces.com/hely-w...stabilizer.htm
You should be able to find something similar in a sports store for about $20 US.
3) Every time you dislocate a kneecap the ligaments get stretched, thus making it more likely to occur in the future. Worst cases they will go in an tighten those ligaments by shortening them. My doctor told me this was next for me if he ever saw me again.

Re: Kneecap Dislocation
 

[ QUOTE ]
Drew,

It sounds like you have a "bucket handle tear" of the Meniscus.


[/ QUOTE ]

doubt it

as was correctly stated earlier, by someone else, menescii are INSDIE the knee joint,

the Patella is OUTSIDE, the Knee joint

Re: Kneecap Dislocation
 

hoterdoc,

I know exactly where the patella is. Maybe the OP doesn't understand what is exactly going on. The action that happens when you extend and flex your leg is called the "Screw Home Movement" and this is where in the last few degrees of extension, the small degree of rotation that occurs between the tibia and femur that "locks" the knee joint in place are rotationally screwed together (screwed home). When beginning flexion from full extension, the knee joint "unscrews" and the rotation is reversed.

Your patella ALWAYS essentially locks and unlocks itself. The only part of the knee that locks from injury is the meniscus. When you tear your cruciate or your collateral ligaments the exact opposite of "locking" happens, your leg is loose because those ligaments are there for stability in internal/external rotation, flexion, and extension--w/o one of these ligaments all of the sudden your leg hasn't any stability.

Everything he said adds up to a bucket handle tear.

1) His knee locks up
2) Bucket handle tears are the most common tears in the knee that are overlooked and the patient is sent home
3) It hurts when his knee locks up, not during daily living.

He also said it happens when his knee is in a semi-bent position, this is exactly when the meniscus rolls up and gets trapped in the intercondylar notch.

Please understand that everything he has said in this thread makes it seem that it is almost certainly what I said it is.

Re: Kneecap Dislocation
 

[ QUOTE ]
hoterdoc,

I know exactly where the patella is. Maybe the OP doesn't understand what is exactly going on. The action that happens when you extend and flex your leg is called the "Screw Home Movement" and this is where in the last few degrees of extension, the small degree of rotation that occurs between the tibia and femur that "locks" the knee joint in place are rotationally screwed together (screwed home). When beginning flexion from full extension, the knee joint "unscrews" and the rotation is reversed.

Your patella ALWAYS essentially locks and unlocks itself. The only part of the knee that locks from injury is the meniscus. When you tear your cruciate or your collateral ligaments the exact opposite of "locking" happens, your leg is loose because those ligaments are there for stability in internal/external rotation, flexion, and extension--w/o one of these ligaments all of the sudden your leg hasn't any stability.

Everything he said adds up to a bucket handle tear.

1) His knee locks up
2) Bucket handle tears are the most common tears in the knee that are overlooked and the patient is sent home
3) It hurts when his knee locks up, not during daily living.

He also said it happens when his knee is in a semi-bent position, this is exactly when the meniscus rolls up and gets trapped in the intercondylar notch.

Please understand that everything he has said in this thread makes it seem that it is almost certainly what I said it is.

[/ QUOTE ]

this sounds exactly right. The first time did happen when I was young and wearing cleats. I grew up playing baseball and soccer.

Is this something worth seeing a specialist over if they are hard to detect, and no particular cure?

Re: Kneecap Dislocation
 

Thanks for the correction...thats what I get for not looking things up that I think I remember....

MM MD

Re: Kneecap Dislocation
 

[ QUOTE ]
this sounds exactly right. The first time did happen when I was young and wearing cleats. I grew up playing baseball and soccer.

Is this something worth seeing a specialist over if they are hard to detect, and no particular cure?

[/ QUOTE ]

This all depends on you. How bad is it? Can you live with it? If it is a problem I would see a specialist, especially since they will now have an idea of what to look for. The reason it is hard to detect is b/c they aren't looking for it and "cure" is the probably the wrong word since it is something you fix.

Good luck with this either way.

Re: Kneecap Dislocation
 

Ive lived with it for 17 years. It hurts like hell when it happens but it doesnt happen everyday. The only real problem is I find myself being careful how I twist and bend my knees and when I play sports I try to go easy on my knee.

Im just worried if it "pops" out 10, 15, 20 more times its gonna ruin my knee and cripple me with arthritis.

Re: Kneecap Dislocation
 

Do squats with perfect form--no lateral movement of the knees. Eventually you'll rectify the problem by strengthening the muscles that keep the kneecap in place.

Re: Kneecap Dislocation
 

Wow, we have a lot of docs lurking. There should be an "Official Ask Dr. OOT" where we can get medical advice.

Re: Kneecap Dislocation
 

o.k.,
I admit I could be wrong, and may indeed be a meniscal injury,

I presumed the OP was correct, when he self diagnosed a 'kneecap' dislocation. After 9.5 years of Emergency Medicine, I well know the dangers of ASSuming anything. ( no offense intended)


to settle it, a picture is worth a thousand words, as they say . . .

when it happens, does it look like THIS???

Re: Kneecap Dislocation
 

in exchange for some coaching?

Re: Kneecap Dislocation
 

[ QUOTE ]
o.k.,
I admit I could be wrong, and may indeed be a meniscal injury,

I presumed the OP was correct, when he self diagnosed a 'kneecap' dislocation. After 9.5 years of Emergency Medicine, I well know the dangers of ASSuming anything. ( no offense intended)


to settle it, a picture is worth a thousand words, as they say . . .

when it happens, does it look like THIS??

[/ QUOTE ]

Oh, I sure do understand that bolded part and you are completely right and it is why I realize you could be right and I may very well be wrong. This is also why he should probably see a specialist and not have this diagnosed blindly over the internet.

The reason it sounded meniscal was b/c of the locking and pain only during this locking.

The picture you showed me was just a subluxed kneecap right?

Like you said, I could be wrong but a dislocated knee cap will be very tender, swell, and he will have constant pain. I had thought he said it didn't hurt until his leg was in a certain position and then it "catches" and "locks."

He hasn't said anything in this thread that would lead me to think otherwise, even from your picture...but like you said nobody is every a 100% right--so uh thanks for pointing that out.

Re: Kneecap Dislocation
 

[ QUOTE ]
I've dislocated one knee 3 times. The first time the kneecap inverted, so it was out of the groove on the outside of my leg and flipped so that the side that should face the knee joint was facing out. This REALLY sucked.


[/ QUOTE ]

I don't want to read this thread any more.

Re: Kneecap Dislocation
 

I've had lots of problems with kneecap dislocation. The first time it happened was on the last play of a football game in high school. A player dove and hit my knee from the outside which caused my knee to buckle sideways (I swear it touched the ground). It buckled so far that my kneecap actually dislocated outward. Another player fell on top of me and bent my knee while my kneecap was off which tore my mcl and a bunch of the meniscus. Needless to say, I was about in shock when I reached down and felt me knee. I had NO idea what it was and thought I broke my leg. The guy on top of me immediately started asking me if i was alright becuase he heard the sound my knee made. Before the coaches got out to the field though, I rolled over a few times and it suddenly popped a few times really loudly and all of a sudden, everything was back in place. I couldnt convince them my knee had been all bent out of position, so they didnt take me to a doctor till the next day. I think my bursa sack ruptured and so my knee was HUGE the next morning.

I had two surgeries to remove all the cartilage that tore and to repair my ligament and remove a bone chip. It sucked.

A year later, I had the same exact thing happen when a guy fell into my knee during a basketball game. Even with a big knee brace on, it dislocated and stayed out. I knew what it was immediately though and reached down to try and pop it back in right away. It worked, but after this, I was told not to play football or basketball again.

I have problems now spraining it randomly or it buckling during exercising. Also, cold weather makes it really sore.

The piece of cartilage the removed from my knee was so large, my physical therapist kept it preserved in a jar and uses it as a paperweight! I swear.