Patellar Dislocation: Orthopedic Allen

by Administrator 22. July 2017 05:08

The patella, commonly called the kneecap, is one of the main bones that make up the knee joint and is to the front of the joint. It is a triangular sesamoid bone (i.e. a bone embedded in a tendon) that sits in the patella-femoral groove which is a hollow or notch at the end of the thigh bone (femur) – the end where it meets the shin bone (tibia). It is held in position by a number of tendons and ligaments which let it move up and down the groove when the leg is bent or flexed at the knee joint.

In some cases, the patella slips out of the patellofemoral groove partially (Patellar Subluxation) or totally (Patellar Dislocation) - causing severe pain and affecting the movement of the knee joint. The dislocation is always to the outside of the joint. Athletes are among the most affected group given the nature of their exertions.

Dislocation of the kneecap is different from dislocation of the knee. Dislocation of knee is when the femur and tibia lose contact. Dislocation of kneecap is when the kneecap is dislocated from the patellofemoral groove on the femur.

Causes

  • Sudden forceful  twist or turn of the knee joint
  • Direct hit or blow on the leg or the knee
  • Congenital predisposition and deformities
  • Faulty alignment of the joint
  • Using inappropriate shoes which do not lend proper support to the knee
  • Excessive stress as in athletes and sportspersons
  • Past injuries of the knee joint or knee cap which did not heal properly
  • Incorrect posture while lifting heavy objects  

Symptoms

  • Swelling, tenderness and inflammation
  • Severe pain immediately on injury – often reported as pain inside the kneecap
  • Visible dislocation of the patella
  • Locking of the knee
  • Impaired and painful mobility of the knee

Diagnosis

  • Thorough physical examination of the injured knee and investigation of patient’s medical history for past injuries, congenital predisposition, etc.
  • Palpation the knee to ascertain the location of damage and the extent of dislocation
  • X-ray
  • MRI scan

Treatment

  • The doctor may suggest to avoid any stress on the knee joint/kneecap
  • The knee should be rested - keeping the leg elevated at the level of the chest
  • Painkillers and anti-inflammatory medicines may be prescribed
  • Compression with a soft bandage
  • Ice packs to prevent/reduce swelling
  • Immobilization of the knee joint using a cast or a knee brace for a couple of weeks
  • Physiotherapy may strengthen the hamstring and quadriceps
  • Orthotic devices may be inserted in shoes to lend support to the knee joint/patella
  • Special tape to improve the alignment and stability of the knee joint
  • Surgery in extreme cases, recurrent injuries because of improperly healed injuries in the past or because of congenital abnormalities

We, at OrthoTexas, offer treatment for various orthopedic conditions. Schedule an appointment with our physicians for complete diagnosis and treatment.  You can visit us at 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013 or call at (972) 727 – 9995.

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Orthopedic Treatment For Baker’s Cyst

by Administrator 25. February 2017 02:28

A fluid filled cyst or small sac that forms behind the knee joint is referred to as the Baker’s Cyst. It is also named as Popliteal Cyst. This condition occurs when the joint functioning is hampered due to an internal cause such as damage to the soft tissue structures, Arthritis etc. Such conditions provoke excessive synovial fluid development within the joint which tends to get stored in a soft tissue sac resulting in the formation of a cyst. In normal conditions, the synovial fluid helps to reduce friction between the constituent bones and makes it feasible for us to flex, rotate and move the legs and the knee. However, excessive build up can cause some discomfort which may require immediate medical attention.

Causes

  • Knee injury may alter the flow and distribution of fluid in the joint
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Damage caused to the joint cartilage

Symptoms

  • Pain while flexing the knee
  • Tightness due to the fluid accumulation as the skin around the joint also stretches
  • Swelling or inflammation at the back of the joint
  • In case the fluid filled sac breaks and the fluid outflows into the lower leg, redness and inflammation may occur in the lower extremities
  • Visibly prominent bulge behind the knee
  • Some patients may feel as if water is running down their legs
  • Inflammation in the calf area

Diagnosis

  • The affected joint and leg are observed in detail and the patient may be questioned about the symptoms, past injuries and the onset of the condition
  • MRI test may be required for detailed view of the knee joint and the affected soft tissue structures
  • X-ray imaging may be done
  • Ultrasound testing may be suggested

Treatment

  • The cyst tends to dissolve on its own over the time in most cases. If the symptoms persist or get aggravated, the following methods may be adopted.
  • Draining the excess fluid using a needle which is referred to as Needle Aspiration
  • Ice therapy may provide relief
  • Injecting steroids into the joint to reduce inflammation and pain
  • The knee may be wrapped in a removable bandage for slight compression and support
  • Weight bearing should be avoided for some time and use of crutches or a walker may be recommended
  • Some pain killers and anti inflammatory medicines may be prescribed
  • Maintaining a healthy body weight to avoid stressing the joint may be recommended
  • Gentle exercises that promote range of motion may be incorporated in the daily schedule
  • In case the underlying cause is a cartilage tear, surgery may be required to treat it
  • Physical activity needs to be avoided for some time and the affected joint should be given adequate rest

For diagnosis and treatment of Baker’s Cyst, visit the knee surgeons at OrthoTexas. To request an appointment, you can call at (972) 727 - 9995.

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