What to Do If You Dislocate Your Kneecap «

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What to Do If You Dislocate Your Kneecap

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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  • Diane Hennessey LaMont

    Every now and then if I move my leg one way it seems like my knee goes the other way, popping out of place. It hurts and I have to straighten the leg and pop it back in place. Usually in the tub or sitting. Why does this happen?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      If you’re referring to your kneecap and not your joint, it could be slightly loose kneecap. If it’s checked out and is that, sometimes some exercises or physical therapy can help.

  • John Ritter

    Sorry hit enter, what to do when surgery won’t even keep it in, first surgery was at 15 then at 35 now its over 12 yrs and it still goes out. What else can be done?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Call around and try to find an orthopedist in your area who has an interest, not only in knees, but in patellar dislocations or at least has treated a lot of them. Then go in for an evaluation and to discuss your options along with the pros and cons of each–surgery, injections, physical therapy, etc.

  • John Ritter

    I had two surgery’s and it still dislocated and it hurts more than broken bone to me. I was told bone under kneecap isn’t curved enuf so that might be why just moving muscles and tendons over knee to try to the it down might not be enuf to keep it in.

  • Emsikj

    I have what was called by my orthopedist “loose joints” and my mom is double jointed. For the past 18 years (since I was 13) I have had full and partial dislocations of each of my knees, multiple times, at random intervals. For the past few years I’ve been good at being able to “tell” as this was happening and straighten my leg right away in order to prevent it from coming out. It’s been pretty successful. At first, they were hoping id outgrow the condition at 18, but that didn’t happen. I tried wearing a knee brace but it put pressure on my knee and ground into the bones around it as I bent my leg. I’ve never been told about any treatment before and have always been able to pop it back in and ice/elevate it, but to avoid activities where my leg pivots at the knee and my foot stays planted. Since then I’ve done that, but have also been through two pregnancies, which may have also weakened my tendons. Today it came out fully (hasn’t happened in a while) and again was able to put it back, iced it, was and am able to weight bear and started having full range of motion, but now have trouble bending it past 90 degrees and am not sure how best to care for it. Can you help? Thanks!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I don’t really know anything to add to by post about that. However long-term, you should definitely have your knees evaluated by an orthopedist that has a special interest in knees. Now is a good time. After the evaluation you should asks the pros and cons of treatments like aggressive and intense physical therapy or surgery–what are the chances that they would help. If not that, what might. Unless the ortho tells you otherwise and you get a customized brace, I don’t think it’s a long-term answer. And since you’re continuing to have problems, hopefully there are better alternatives than just. avoiding certain activities. Every time you dislocate, you run the risk of damaging the cartilage that pad it from the rest of your knee, chipping off fragments, and bad arthritis of the area down the road.

  • Lucy

    My boyfriend dislocated his kneecap (full dislocation) about four days ago. He went to the doctor and was sent home with instructions to rest, keep weight off of it and report back if he doesn’t see improvement in three weeks. We don’t have insurance, so going back before that is prohibitively expensive, but the doctor didn’t do x-rays or anything and said that he “could tell” that nothing was torn by the lack of pain my boyfriend was in.

    We reset the kneecap together after it popped to the side of his leg when he stepped on it. We got it reset in about four minutes. The knee is swollen and his foot swells up off and on.

    He can’t put any weight on it and he can barely move it at all after four days. Is this normal? I don’t trust that the doctor knew what he was doing, but we just don’t have the money to go to another one.

    When he’s in the bathtub, he can almost straighten it, though.

    I’m just looking for some confirmation that the lack of motion and swelling being present is normal after four days. He’s in a knee brace, we’re icing it, elevating it, doing epsom salt baths and keeping weight off of it. Lots of ibuprofen to control the pain.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      It’s consistent with that, but that doesn’t rule out another injury. But, yes, it is consistent. In general, as long as there’s no weight bearing and there’s a brace, nothing gets injured worse (unless it were cutting off circulation). But, at some point, if the injury is not getting consistently better, it has to be rechecked. The problem is no injury is exactly the same.

      • Lucy

        Thanks so much for your reply!

  • Jessica

    Hello!

    I dislocated my patella a few days ago during my dance class and it was placed back spontaneously by the paramedics when they arrived. I don’t go to hospitals often so I’m not sure where I was exactly but I do remember being in an acute ward or something along those lines. I couldn’t walk or move my knee in anyway however all the doctor told me was to go to physiotherapy and to ice the swelling. No braces or crutches or anything like that, not even mentioned now I think about it (however i am using my own elastic medical bandage and my own crutches on my own choices, am I making the right decision by taking matters into my own hands?). I was wondering how long I should use these things for? And when can I start walking again? Also how far in the future can I dance again? It’s been 5 days and I can sort of limp walk now but I’m afraid that will just cause more damage.

    Thank you in advance.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Being a dancer is all the more reason you should have your knee checked out soon, and before returning to dancing.

  • Ashtan

    The way I dislocated my knee: I jumped up to catch a football (we were playing on a hill) and I slid. The other kids were shocked. My knee was 2 inches to far to the left. I didn’t know these instructions for popping it back at the time ( did it myself ) and I actually did exactly what it said. I have dislocated my knee a time before sliding in baseball so I have a brace and crutches luckily.

  • Andrea

    I’ve dislocated my patella since I was 12. I finally had surgery on it back in 2008. Since then I have dislocated it three times, the third time was tonight. How crucial is it that I see the doctor about it? I don’t have time for a surgical procedure right now. Is there anything I can can do at home?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sounds like you should already pretty well know. In general, it’s stay off of it if it hurts, splint for at least 3 weeks and then physical therapy to strengthen up the muscles and try to prevent it from happening again. But, I would check with a doctor and find time to see with an orthopedist who does a lot of this type of surgery, have an exam, and ask questions about what’s your best options with or without surgery.

  • marria

    Hi Doctor, right now I’m at the age of 16 but since 3-4 years ago my knee caps have dislocated from then every couple of months or just in weeks, partially because I’m wary of edges of furnaces such as tables as they actually knock the knee caps out side ways. I normally push the knee cap back in since I can’t move that leg then rest and massage it for a couple of minutes. I simply can’t understand what it is, is it very serious? I’m afraid that I may be in the middle of something important or even carrying my nephew and my knee decides to dislocate suddenly. It’s also kind of scary that I have to actually move the knee cap which is sticking out, and can happen anywhere at any time.
    Oh and after I put it back in place it doesn’t hurt very much, just a sort of numb tingling feeling and I don’t really think there’s a popping sound, maybe a dull quiet sound? I’d very much appreciate your answer, thank you!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Anyone whose kneecaps are dislocating should see a doctor. Physical therapy might help but, often, surgery is needed.

  • Jenny

    My daughter dislocated her knee this weekend she was taken to the emergency room & they popped back into place & did xrays & nothing was broken but was told to see orthopedic surgeon as soon as possible. The problem we are having is we don’t have Insurance & the fee just to see doctor is $350 what other options do we have. They placed her in a full leg brace didn’t know if we could go to smaller knee brace until we can get the money to go see the doctor?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      In general most knee immobilizers are kept on for 1-2 weeks depending on the judgement of the doctor after the exam. Smaller braces are kept on an additional 2-4 weeks. Here’s a pretty good link http://orthoinfo.aaos.org/topic.cfm?topic=A00707