Patellar dislocation
A patellar dislocation occurs when the kneecap moves out of its normal position, usually toward the outside of the knee. The kneecap may sometimes relocate spontaneously or require reduction by a healthcare professional.
After a patellar dislocation that has spontaneously relocated, the player may have pain, tenderness, some swelling and a feeling of uncertainty in the knee.
Patellar dislocation often occurs when the body twists while the foot is planted, particularly when the knee moves into an unfavorable position. Direct trauma to the knee can also cause a dislocation.
Common situations
- •Rapid change of direction with the foot planted
- •Twisting or awkward loading of the knee
- •Landing after a jump
- •Direct trauma to the knee
After a patellar dislocation, structured rehabilitation is important. Strength in the thigh and hip together with good neuromuscular control may contribute to better knee stability.
- •Train thigh and hip strength
- •Develop good knee and single-leg control
- •Train balance and neuromuscular control
- •Follow the rehabilitation plan after a previous dislocation
Stop play and training and have the knee assessed. Even if the kneecap has returned to its normal position, the injury should not be considered insignificant.
Control pain and restore mobility
Control swelling and pain and progressively restore normal range of motion.
Goals
Good daily function and improved knee control.
Progression criteria
Able to walk and perform basic exercises without significant pain or instability.
Strength and stability
Progressive training of the thigh, hip, balance and neuromuscular control.
Goals
Restore strength and control for running and football.
Progression criteria
Able to tolerate single-leg loading, jumping and progressively more football-specific movements without a feeling of instability.
- Good range of motion
- Minimal or no swelling
- Adequate thigh and hip strength
- Good single-leg and knee control
- Able to tolerate jumping, landing and changes of direction
- No feeling of patellar instability
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Patellar dislocation
A patellar dislocation occurs when the kneecap moves out of its normal position, usually toward the outside of the knee. The kneecap may sometimes relocate spontaneously or require reduction by a healthcare professional.
Mild — Lättare förstagångsbesvär kan kräva flera veckors rehabilitering, men återgångstiden varierar beroende på skadans omfattning och eventuella samtidiga skador.
Symptoms
After a patellar dislocation that has spontaneously relocated, the player may have pain, tenderness, some swelling and a feeling of uncertainty in the knee.
Acute Treatment
Stop play and training and have the knee assessed. Even if the kneecap has returned to its normal position, the injury should not be considered insignificant.
Rehabilitation
Control swelling and pain and progressively restore normal range of motion.
Goals
Good daily function and improved knee control.
Progression criteria
Able to walk and perform basic exercises without significant pain or instability.
Progressive training of the thigh, hip, balance and neuromuscular control.
Goals
Restore strength and control for running and football.
Progression criteria
Able to tolerate single-leg loading, jumping and progressively more football-specific movements without a feeling of instability.
Return to Play
- ☐ Good range of motion
- ☐ Minimal or no swelling
- ☐ Adequate thigh and hip strength
- ☐ Good single-leg and knee control
- ☐ Able to tolerate jumping, landing and changes of direction
- ☐ No feeling of patellar instability
Moderate — Återhämtningen kan ta flera veckor till flera månader beroende på skadans omfattning, stabilitet och eventuella samtidiga skador.
Symptoms
Significant pain, swelling and uncertainty in the knee may occur. The player may feel that the kneecap wants to move out of position or that the knee is unstable.
Acute Treatment
Stop activity and seek medical assessment. Do not attempt to manipulate or relocate the kneecap yourself.
Rehabilitation
Control pain and swelling and restore range of motion and basic function.
Goals
Normalize walking and basic knee function.
Progression criteria
Able to bear weight and perform basic strengthening exercises without significant worsening.
Progressive training of the thigh, hip, balance and movement control.
Goals
Restore stability and load tolerance for football.
Progression criteria
Able to tolerate running, jumping and changes of direction without significant pain, swelling or instability.
Return to Play
- ☐ Good range of motion
- ☐ No significant swelling
- ☐ Adequate strength and control
- ☐ Good stability during single-leg loading
- ☐ Able to tolerate football-specific jumping and changes of direction
- ☐ Individual medical assessment
Severe — Allvarligare luxationer och skador med samtidiga ben-, brosk- eller ledbandsskador kan kräva flera månaders rehabilitering.
Symptoms
If the kneecap remains dislocated, the knee may be visibly deformed and very painful. Significant swelling may occur, and cartilage or bone injuries may also be present.
Acute Treatment
Seek urgent medical care if the kneecap remains dislocated or if there is severe pain, deformity, impaired circulation or altered sensation. Do not attempt to relocate the kneecap yourself.
Rehabilitation
The position of the kneecap and any injuries to bone, cartilage or ligaments are assessed. Early rehabilitation focuses on pain, swelling, range of motion and function.
Goals
Restore basic knee function and control symptoms.
Progression criteria
Good range of motion, controlled swelling and sufficient strength for progressive training.
Strength, balance, jumping, running and changes of direction are progressively reintroduced according to an individualized rehabilitation plan.
Goals
Restore knee stability and the function required for football.
Progression criteria
Able to complete relevant functional testing and football-specific loading without pain, swelling or instability.
Return to Play
- ☐ Good range of motion
- ☐ No significant swelling
- ☐ Adequate thigh and hip strength
- ☐ Good single-leg and knee control
- ☐ No perceived patellar instability
- ☐ Able to tolerate jumping, landing, changes of direction and football-specific loading
- ☐ Medical assessment and individualized return-to-play plan
When to Seek Medical Care
A patellar dislocation should be medically assessed even if the kneecap has spontaneously returned to its normal position.
- The kneecap remains out of position
- Visible deformity
- Severe pain or swelling
- Altered sensation or circulation in the leg or foot
- Inability to bear weight normally
- Suspected fracture or cartilage injury
References
- Dislocated Kneecap — American Academy of Orthopaedic Surgeons (https://orthoinfo.aaos.org/en/diseases--conditions/dislocated-kneecap-patellar-dislocation/)