The kneecap is under that brown tendon.

by James Hubbard, MD, MPH

A dislocated kneecap is another one of the multiple knee injuries you can get. And you won’t be going far until it’s fixed. It’s painful, most of the time there’s a lot of swelling, and your knee can’t straighten.

Obviously you have to get to a doctor as soon as you can to make sure nothing else is injured and to put it back in place. Often, the doctor will also drain some of the blood off that’s accumulated around it (which can ease the pain dramatically).

But if getting to a doctor is impossible, here are some things you can try.

Why You Shouldn’t Always Put It Back in Place

Treatment depends, to an extent, on what sort of injury we’re talking about. Beware of bad breaks.

Sometimes it just takes twisting wrong to dislocate the kneecap. Other times there’s an added bump to one side of the kneecap. (For instance, you hit the side of a table while you’re twisting, and the kneecap dislocates to the opposite side of where you hit it.)

When the dislocation comes from something like either one of those scenarios, you can pretty well assume you didn’t break anything. Maybe a there’s little crack in the kneecap or tibia (lower leg bone), but there’s no big break that’s going to dislocate too.

The more forceful the hit, the less you can assume there’s no broken bone. So if there’s been major trauma, just splint the knee in the position it feels best and get off of it (or use crutches). Then get to a doctor as soon as you can.

For those minor bumps and twists, it’s best to try to put the kneecap back in place right away (if you can’t get to a doctor) before more swelling sets in and makes it harder to do.

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How to Relocate a Dislocated Kneecap

Here’s how to put a dislocated kneecap back in place:

  1. If possible, ask someone to help. Your leg will need to flex and straighten, and it’s best to have someone do that for you. Straightening your leg on your own requires contracting the quadriceps muscle in your thigh. That tightens the tendon that connects to your kneecap. The tighter the tendon, the harder it is for the kneecap to move back into place.
  2. Flex your hip by sitting. If you’re lying down grab around your thigh and pull it toward you about 30 degrees or so. This relaxes your quadriceps muscle a bit, which loosens that tendon I mentioned in step 1. (If you don’t know what I’m talking about, read the “Anatomy” section of my post on Osgood-Schlatter disease.)
  3. Have someone slowly straighten the knee while the hip is bent. Or do it yourself if no one is available. Apply gentle pressure to the side of the kneecap to try to tease it back in place.
  4. Go slowly. You can try several times, but never force it since you could break something or make an already broken bone much worse.

After the kneecap is back in place:

  1. Wrap it with an elastic bandage or use a knee brace. This does little or nothing to keep the kneecap in place, but moderate compression can keep the swelling down.
  2. Stay off of your injured leg if you can and apply ice packs, if available, for 10 minutes at a time intermittently. Use a cane or crutches.
  3. Get to a doctor as soon as possible for further evaluation to see what is torn or broken.
  4. Expect it may happen again—maybe not right away, but somewhere down the road. If it dislocates over and over again, you’re going to need surgery to keep that from happening.

Has anyone ever had a kneecap dislocate? Painful? Scary? How did you get it back in place? How’s it doing now?

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Photo by April J. Gazmen on Flickr.