Dislocated kneecap

[JohnRoman]

My 15 yr old daughter dislocated her kneecap and then it was popped back into place later at the ER. No big swelling, no noticeable bleeding. She says the knee doesn't really hurt, feel thick from swelling/inflammation, etc. However, she has been in a brace and on crutches, for the most part, since it happened 3 1/2 days ago.

Waiting for the MRI report to come back. Ortho said that would determine whether surgery or PT would be the way to go. I'm having a hard time even thinking about surgery. Am I crazy or am I missing something on the need for surgery?

I hear this is not uncommon for children her age and I had the same thing happen to me at 13 but mine was worse. I'm completely in the dark, what advice do you have on this.

[Mark Rippetoe]

A dislocated patella is going to involve a torn retinaculum. I don't know how well they can repair this. Mine scarred down pretty well. An injury bad enough for a brace and crutches argues for the surgery. But get a couple of medical opinions, please.

[BillBrownley]

I dislocated my patella, and in the process the patella tendon tore. I walked around for a couple of days before I went to see the doc. No bad pain (well, except when it tore) or swelling. When he came back after looking at MRI/Xray, I asked if I could just rehab it with exercise.

He and the intern just about fell over laughing. Showed me the pictures. My knee cap was like halfway up my thigh. So--if the tendon tore--surgery is the only option. If not--listen to your doc. At least at first.

[JohnRoman]

A dislocated patella is going to involve a torn retinaculum. I don't know how well they can repair this. Mine scarred down pretty well. An injury bad enough for a brace and crutches argues for the surgery. But get a couple of medical opinions, please.

Coach thank you for your advice. The brace and crutches are a precaution, I don't know if I would say they are a necessity. I just know when it happened to me that my knee popped out several more times over the next few weeks. I'm sure I did more damage on those instances and I wanted to try to save her from that.

I will definitely get more opinions if the surgery route is chosen. We hope to go with PT (sorry for using a bad word) and hopefully it will stay in place.

Mine has not popped out in a few years but I can definitely tell the difference in the last few months that I have been squatting correctly (or at least trying to). My knee feels MUCH stronger now.

Thank you for your time, advice, the resources you provide and for giving back.

[Timothy]

So I know a person from High School who was born without knee caps. How does this work? And why does one need Knee caps? I was about to ask this question, but decided to research it first.

http://en.wikipedia.org/wiki/Nail%E2...tella_syndrome Here is the link if anyone is interested.

[Mark Rippetoe]

The patella functions as a leverage optimizer for the tendon that extends the tibia, and provides a way to protect the tendon from the condyles it crosses. Hard to walk without a patella. This genetic disorder is thankfully uncommon.

[MightyJoeYoung]

Rip, while we are on the subject of knee oddities, can you explain to me how Hines Ward was born without an ACL and managed to play relatively injury free for 13 years, yet when someone tears an ACL, they are out for many months?

[kako]

I once got a pretty severe injury in my toe joint by kicking really hard into ground when playing soccer. I was blown away by how much conflicting diagnosis and treatment options I was given from different specialists. I went to 4 podiatrists before making a decision. The first one I went to which was the most experienced and a very reputable surgeon recommended that I definitely do surgery for the repair. The other 3 I went to didn't see any need for surgery and I went with that. And 3 years later my toe is perfectly fine.

[Mark Rippetoe]

Rip, while we are on the subject of knee oddities, can you explain to me how Hines Ward was born without an ACL and managed to play relatively injury free for 13 years, yet when someone tears an ACL, they are out for many months?

Sure: you are wrong in your assumption. Many people play on a torn ACL without a repair, as soon as the swelling subsides. What do you think people did 100 years ago when this injury occurred?

[Bazza20]

I dislocated my knee cap playing Aussie rules footy about 6 or 7 years ago. Knee swelled up like a basketball, had bruising from my ankle to my groin and could hardly walk for weeks. Did PT for a couple months and then just lots of squatting and so far haven't had another problem since.