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Patellar Subluxation

What is Patellar Subluxation?. A subluxing patella is a temporary, partial dislocation of the kneecap from its normal position in the trochlea on the femur. This trochlea is located between the femoral condyles.. . **Picture shows patella when it subluxes and dotted lines show where patella should be normally.**.

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Patellar Subluxation

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    1. Patellar Subluxation Andrew Tees February 28, 2007

    3. Etiology - Deceleration with simultaneous cutting in the opposite direction (valgus force at the knee) - The Quadriceps contract and sucks the patella out of place and pulls it over the lateral femoral condyle. ? ? ? - Pt. may be predisposed to injury if they have abnormal gait patterns and a shallow trochlea for the patella.

    4. Sport Specific Injury? Patient who do sublux their patella usually report MOI as being a pivoting, twisting, or cutting motion which is most common in sports such as football and basketball.

    5. Signs & Symptoms - Pain behind the knee, and pain with straightening or bending the knee. - Swelling - Restricted ROM - tender over adductor tubercle - Visible - Pt. may report a sensation of the knee “giving away.” - X-ray will help reveal lateral displacement of the patella.

    6. Associated Injuries Osteochondral Fracture of the lateral femoral condyle and/or patella. Chondromalacia Patella- softening or deterioration of the articular cartilage Patellofemoral Stress Syndrome- result of lateral deviation of the patella in the femoral groove.

    7. Differential Dx Chondromalacia Patella Jumper’s Knee Patella Tendon Rupture Larsen-Johanssen Disease Complete dislocation of the Patella

    8. Treatment/Management Physical Therapy- Pt. sent to PT to strengthen the quadricep muscles to realign the pull of the patella. New research shows that strengthening the hip abductors and flexors offers better control of the patella. Bracing and Taping Horshoe pad Knee sleeves (Bottom Picture) Patellar Strap (Top Picture)

    9. Treatment/Management (Cont.) Better Footwear- The type of shoes you wear contribute greatly to your gait cycle. -Ex. Special running shoes may promote better gait during running and help decrease pressure on the patella. Remember: Just because the shoe looks good doesn’t mean it’s best for you. Surgery? -Most patients are cured by PT but those who suffer from severe pain and recurrent patella displacements may choose surgery.

    10. Patellar Subluxation Things to remember: Subluxation is an incomplete or partial dislocation. Meaning the injured structure comes out of place but goes back in on its own. Luxation is a complete dislocation that does not go back into place on its own, requires medical attention and manual reduction of the joint.

    11. Works Cited Cluett, Jonathon MD. About: Orthopedics. http://orthopedics.about.com/cs/patelladisorders/a/kneecapdisloc.htm Duke University, School of Medicine. “Subluxation/Dislocation of the Patella.” http://www.wheelessonline.com/ortho/subluxation_dislocation_of_the_patella University of Michigan, Health System. Sports Medicine Advisor 2005. “Patellar(Kneecap) Subluxation.” http://www.med.umich.edu/1libr/sma/sma_subluxin_sma.htm Knee Pain Info Website. “Patellar Stabilizing Braces.” http://www.kneepaininfo.com/bracesPatellarDislocation.html

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