What is patellar dislocation?
According to Dr. Manish Dhawan - Senior Consultant Orthopedics, Sir Ganga Ram Hospital, New Delhi (India), patellar dislocation is a condition when the patella, a small triangular bone in the front of the knee, is displaced from the groove on the femur (pulley).
This can cause pain, discomfort, and loss of balance, but sometimes the kneecap is only partially dislocated (subluxated), allowing some movement. A dislocated kneecap is often caused by an injury or deformity of the muscles, ligaments, and knee joint, which affects the stability of the kneecap.
Why are women more affected?
Women are more susceptible to patellar dislocation than men due to certain specific anatomical and physiological factors, says Dr. Manish Dhawan.
Accordingly, the main reasons include:
Wider Q angle: Women have a wider Q angle (the angle between the hip, knee, and tibia) due to wider hips, which puts pressure on the knee joint and makes the patella more likely to dislocate outward.
Shallow pulley groove: The femoral groove (pulley) in women is shallower, making the patella more prone to dislocation, especially during strenuous exercise.
Less muscle around the knee: Women have less thigh muscle, which reduces stability of the knee joint and patella.
Hormonal effects: Estrogen makes ligaments softer, making joints more vulnerable to injury and the kneecap more likely to dislocate.
Movement structure and habits: Women often participate in sports with many movements that change direction quickly, which can easily cause the patella to dislocate when the body is unstable.
Causes of patellar dislocation
Direct or twisting blows: Direct impacts to the knee or twisting movements can strain or damage the stabilizing muscles and ligaments, causing instability of the kneecap.
Structural abnormalities: Problems such as patella luxation (high kneecap) or trochlear dysplasia (shallow femoral groove) make it easier for the kneecap to shift outward with changes or strong impacts.
Repetitive stress: Participating in high-impact sports or activities without adequate muscle-strengthening exercises can lead to overuse of the knee and a tendency to dislocate.
Patellar Dislocation Management and Treatment
According to Dr. Dhawan, most cases of patellar dislocation can be treated without surgery. Treatment steps include:
Stabilize and reduce stress: Initially, use a knee brace or crutches to help stabilize the joint and reduce stress on the knee.
Strengthening muscles: Once inflammation decreases, exercises that strengthen the quadriceps and muscles around the knee can help improve stability and reduce the risk of recurrence.
Reducing swelling and pain: Ice packs and anti-inflammatory medications are often recommended to reduce discomfort and swelling.
Surgery (if necessary): If instability persists despite the above measures, surgery may be considered. In younger patients, surgery may involve realigning the patella without touching the bone. In older patients, surgery may involve cutting and realigning the bone to improve knee function.
