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Dislocation Reduction of the Patella

  • Editor(s): Todd W Thomsen, MD, Gary S Setnik, MD, FACEP
  • Section Editor(s): Phillip M Harter, MD
  • Contributor(s): Carmie Chan, MD
PRE-PROCEDURE
INDICATIONS

Lateral dislocation of the patella.
CONTRAINDICATIONS
  • Intracondylar and superior dislocations require operative reduction.
  • The rare horizontal dislocation may relocate with closed reduction, but surgical reduction is often necessary.
ANATOMY

The patella is stabilized superiorly by the quadriceps femoris tendon and inferiorly by the patellar ligament, which inserts on the tibial tuberosity.
Dislocation of the patella.
Figure 1 :  Dislocation of the patella.

Anatomy of a patella dislocation.
Figure 3 :  Anatomy of a patella dislocation.


PROCEDURE
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Apply medial pressure to the patella.
Figure 4 :  Apply medial pressure to the patella.

Gently extend the leg.
Figure 5 :  Gently extend the leg.


POST-PROCEDURE
CARE
  • Immobilize the leg in extension
    • This may be done by casting or applying a commercially available knee immobilizer.
  • Orthopedic follow-up is necessary because of the need for physical therapy and the high rate of persistent instability.
  • Hospitalization is not required for routine lateral dislocations of the patella.
  • Recurrent dislocation and those associated with an osteochondral fracture may require operative repair.
COMPLICATIONS

There are no reports in the literature of complications from gentle reduction.
Mobilize the knee in extension.
Figure 6 :  Mobilize the knee in extension.

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