For athletes and active individuals, dealing with recurrent patella dislocations can be a frustrating and challenging experience. Each dislocation can impede progress, hinder performance, and increase the risk of further injury. In this insightful blog, Dr. David Guyer, a triple board-certified orthopedic surgeon and sports medicine specialist, shares his expertise on treatment options for recurrent patella dislocations. From preventative measures like physical therapy and stabilization braces to surgical interventions, Dr. Guyer explores various solutions aimed at helping you return to your sports activities with confidence and reduced risk of future dislocations. Whether you’re an athlete seeking to understand your options or someone interested in sports medicine, this blog will provide valuable information to guide you on your path to recovery and optimal performance.

Non-Surgical Options

The first line of defense against recurrent patella dislocations usually involves non-surgical methods. These options focus on strengthening the muscles around the knee and providing support to prevent future incidents.

Physical Therapy

• Physical therapy is a cornerstone of non-surgical treatment for patella dislocations. A well-rounded therapy program focuses on strengthening the quadriceps and other muscles that stabilize the patella.
• Improving flexibility and balance is also pivotal as it enhances overall knee stability, reducing the likelihood of dislocation.
• Therapists may incorporate specific exercises designed to improve alignment and control of the patella during activities such as running or jumping.

Patellar Stabilization Braces

• These braces are specially designed to support the kneecap and help keep it in place during movement.
• Athletes can wear these braces during sports activities to exert additional control over the patella’s movement, decreasing the risk of dislocation.
• However, while stabilization braces can be helpful for some, they are not foolproof and might not work for everyone depending on specific anatomical factors.

Understanding Anatomical Factors

The success of non-surgical interventions like braces and physical therapy can depend on several anatomical factors:

• The depth of the trochlear groove: A shallower groove increases the risk for dislocations as the patella is more likely to slip out.
• Ligament injuries: If the medial patellofemoral ligament (MPFL) is damaged or stretched, the stability of the patella is compromised, leading to increased dislocation risks.
• Bone fragments: Sometimes, a piece of bone may be chipped off during a dislocation, requiring special consideration.

Surgical Options

When non-surgical options have been exhausted, and dislocations continue to occur, surgical intervention may become necessary. Surgery is typically considered after multiple dislocations, particularly when the underlying anatomy predisposes the individual to these events.

Medial Patellofemoral Ligament (MPFL) Reconstruction

• This surgery is the most common procedure for treating recurrent patella dislocations. It involves reconstructing the MPFL to improve the stability of the kneecap.
• Depending on the patient’s condition, the procedure may be performed with or without additional interventions on the bone to properly align the extensor mechanism.

Bony Realignment Procedures

• In cases where there is significant misalignment, or other bone-related issues, surgeons might perform tibial tubercle transfer or trochleoplasty to improve knee stability.
• These procedures realign the patella’s pathway and ensure it tracks properly in its groove.

Post-Surgery Recovery

Recovery from a patella-stabilizing surgery involves a period of immobilization followed by a progressive rehabilitation program:

• The initial phase focuses on managing pain and swelling while protecting the knee.
• Gradually, patients will begin physical therapy to regain range of motion and start strengthening the muscles around the knee.
• Complete recovery typically takes several months, during which patients must follow a tailored rehabilitation program to ensure the best outcome.

Continuing Sports Post-Recovery

Returning to sports after a patella dislocation or surgery is dependent on several factors, including the individual’s progress in rehabilitation and the stability of the knee. Athletes are advised to:

• Engage in sports-specific conditioning programs to prepare the knee for the physical demands of their sport.
• Avoid pushing too hard too soon, as premature return can lead to further injury.
• Stay in touch with their orthopedic surgeon and physical therapist to monitor and adjust their recovery plan.

Conclusion

Dealing with recurrent patella dislocations requires a comprehensive approach that combines initial non-surgical methods and, if necessary, surgical interventions. By understanding the condition and following the proper treatment protocols, athletes can minimize their risk of future dislocations, allowing them to return to their sports activities with confidence and improved knee stability. Remember, each case is unique, and a personalized treatment plan under the guidance of a medical professional is crucial for successful recovery.