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When things are “in the groove,” they’re going smoothly. That certainly is the case with your knee. As long as your kneecap (patella) stays in its groove in the knee, you can walk, run, sit, stand and move easily. When the kneecap slips out of the groove, though, problems and pain often result.
Injuries to the knee often include kneecap (patellar) dislocation or subluxation. The patella is a V-shaped bone that sits in a groove in the thighbone. A patellar dislocation occurs when the kneecap is displaced from the thighbone, and the joint surfaces are no longer touching. A subluxation is a similar injury, where the kneecap becomes displaced, but the joint surfaces are still touching. Patellar dislocations and subluxations are most common in adolescents and younger adults.
During the physical examination, your doctor may ask you to walk around, or to straighten and bend your knee. The doctor may carefully feel the area around your kneecap and take measurements to determine if the bones are out of alignment or if the thigh muscles are weak. In addition, X-rays may be recommended to see how the kneecap fits in its groove. Your doctor will also want to eliminate other possible reasons for the pain, such as a tear in the cartilage or ligaments of the knee.
If the kneecap is only partially dislocated, your doctor may recommend nonsurgical treatments, such as exercises and braces. Exercises will help strengthen the muscles in your thigh so that the kneecap stays aligned. If the kneecap has been completely dislocated out of its groove, the first step is to return the kneecap to its proper place. This process is called reduction. Sometimes, reduction happens spontaneously. Other times, your doctor will have to apply gentle force to push the kneecap back in place. A dislocation often damages the underside of the kneecap and the end of the thighbone, which can lead to additional pain and arthritis. Arthroscopic surgery can correct this condition and restore normal patella alignment. If surgery is required, our surgeons may perform minimally invasive, arthroscopic procedures to limit postoperative pain and scar tissue buildup.