Treating patella instability

Question: I injured my knee playing flag football. I turned to the side and felt a “pop.” My knee was very swollen and it looked as if it came out of place. The emergency room doctor told me I dislocated my kneecap and they pushed it back in place. What now?

Answer: Kneecap or patella instability is a common injury in all athletes, often sustained when twisting one’s body around a planted foot.

Patella instability represents a continuum of injuries ranging from minor incidental episodes of subluxation to traumatic dislocation events. These injuries often tear the kneecap’s most important stabilizing ligament — the medial patellofemoral ligament.

Also, the underside of the kneecap, which is covered with cartilage, can become damaged during the dislocation. In first-time dislocations, non-operative treatment initially includes rest and ice. Afterward, activity modification, focused physical therapy, and a stabilizing brace may be used.

When non-operative treatment fails and the kneecap continues to be unstable, there are several procedures that may help, depending on the specific anatomy of the patient. These surgeries may involve tightening the torn ligament, attaching a new ligament to the kneecap or, sometimes, changing the shape of the bone to add stability. These surgeries are very successful at restoring stability and returning patients to their previous activities.