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Adam B. Cohen, MD

 Patella (kneecap) Dislocation

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Home > Knee Conditions > Patellar Dislocation

Patellar Dislocation and Instability

Overview

Dr. Adam Cohen is a top rated NYC orthopedic surgeon and sports medicine expert who has expertise in the treatment, operative and non-operative, of patella or kneecap dislocations and instability.

The knee joint consists of the patella (kneecap) along with the femur (thigh bone) and tibia (shin bone).   The patella, sits in a groove in the front of the femur and glides up and down when the knee bends and straightens.

When the patella falls out of this groove, it is called a patella dislocation.  Sometimes the patella feels like it is going to come out or almost comes out, this is called patellar instability.

There are several structures which help to keep the kneecap in the groove.  Traumatic injuries to these structures can lead to a dislocation.   Some people are born with anatomic features that predispose them to have patellar dislocations or instability.

Evaluation

As part of the evaluation for a patellar dislocation it is important to know many things.  What were you doing when the patella dislocated?  Is it the first time the patella dislocated?  Has the other kneecap dislocated?  

Examination can reveal important factors to how the kneecap glides in the groove and what factors may contribute to the instability.  Examination can also help decide what the best treatment will be necessary

Radiographs are important because they provide valuable information regarding the different types of anatomic features that may predispose to instability or dislocation.

MRI is also important tool to evaluate if there are any loose cartilage fragments.  It can also determine if the main stabilizer to the knee, the Medial Patellofemoral Ligament, has been torn.

Treatment

Most times patellar dislocations and instability can be treated without surgery.  Sometimes a brace is used initially to stabilize the knee cap until healing can take place.

There are certain situations where surgery is recommended.   For example, sometimes when the patella comes out of the groove, cartilage from the femur or kneecap can sheer off.  This cartilage will sometimes need to be removed and sometimes it may need to be reattached. 

Surgery is also recommended in individuals who have symptomatic instability of the kneecap despite physical efforts.  Anyone who has had multiple dislocations also are candidates for surgery.

Surgeries to address patellar instability include MPFL (Medial Patellofemoral Ligament) reconstruction or Tibial Tuberosity Transfer and sometimes both. Discuss options with your surgeon.