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Kneecap Pain & Dislocation
G2: Your Go-To Knee Doctors in Richmond, VA
There are a number of potential causes of knee pain, ranging from acute damage due to an injury or fall to pain brought on gradually by years of use. The first step to recovery is seeing a knee doctor to diagnose the cause of your kneecap pain. Then, your doctor will work with you to develop a personalized treatment plan to get you back to health.
Damage to Knee Cartilage
Chondromalacia means damaged articular cartilage. This cartilage is normally a hard, smooth layer that cushions bone and allows the joint to move easily. When the cartilage is damaged from injury or years of use, pain can occur. Uneven areas of damaged cartilage can cause swelling and a feeling of “catching,” “locking,” and “giving-way.” If these uneven areas continue to catch over time, the area of damage can get bigger.
Initial treatment for chondromalacia may include anti-inflammatory medications, an exercise program, and recommendations to limit stair climbing, squatting, and kneeling. If this treatment fails, your knee doctor may recommend arthroscopic surgery to help smooth uneven areas of cartilage. If the damage is severe or if the chondromalacia is associated with malalignment or maltracking, then a Fulkerson osteotomy may be recommended.
Mal-alignment and Mal-tracking
The kneecap normally slides in a groove in the thigh bone as the knee bends and straightens. If the kneecap is improperly tilted or not lined up correctly in the groove, pain can occur.
With maltracking, the kneecap partially comes out of the groove as the knee is bent and straightened. This is called subluxation, and it can cause pain and a sense of “giving-way.” Some people are born predisposed to developing these conditions, while others develop it as a result of injury or muscular weakness.
In cases of malalignment, the attachment between the kneecap and the shin bone is out of alignment. This can cause excess stress under the kneecap. In more severe cases the entire lower leg can be out of alignment.
Treatment for maltracking and malalignment varies depending on the patient. It may involve physical therapy with stretching and strengthening exercises, selective taping, and/or bracing, or if symptoms continue, arthroscopic surgery may be needed to repair the joint.
Knee Dislocation
A dislocation occurs when the kneecap completely comes out of the groove. This stretches or tears the ligaments that normally keep the kneecap in its proper location. Occasionally, as the kneecap dislocates, an area of cartilage or bone can become chipped. In these cases, arthroscopic surgery is necessary to remove or replace this loose piece. If there is not a loose piece, then the dislocation can often be treated with a brace that keeps the knee straight for several weeks, which allows the ligaments to heal. This is followed by an exercise program to strengthen the muscles, which further stabilizes the kneecap.
If the kneecap continues to dislocate, then surgical reconstruction can be performed to prevent further pain and injury. This reconstruction would include an MPFL Reconstruction. A Fulkerson osteotomy may have to be added if there is underlying malalignment.
The first step to resolving your knee pain is to schedule an appointment to see the knee doctors at G2 Orthopedics and Sports Medicine in Richmond, VA.
