Ten years ago, I fell while skiing and injured my knee, and since then my knee cap (patella) always dislocates. I’ve always had problems; if I stand awkwardly, it dislocates, and after so much time, my knee started hurting and swelling, and I have fluid in my knee.
The doctor at the Emergency Room looked at it with an ultrasound. Now I’m wondering what I need to do and if it’s normal for my knee to always dislocate.
Thank you in advance.
The symptom description indicates a luxating (unstable) patella. The medical history further suggests that trauma was the initial cause of this instability. The current condition, characterized by swelling and pain, indicates damage to other knee tissues (likely cartilage).
In cases of chronic instability of any joint (in this case, the knee, specifically the patella), over time, there is damage to other parts of the joint, with reactive changes, especially in bone, all in an attempt by the body to reduce instability. Gradually, and sometimes very quickly, this initiates degenerative changes leading to osteoarthritis, which is very difficult to treat. Because of this, joint instabilities that do not settle with persistent physiotherapy (especially exercises) should be surgically stabilized whenever possible.
Depending on the condition of the joint and the patella, it may be possible to stabilize the patella using a procedure called MPFL (medial patellofemoral ligament) reconstruction, which restores ligamentous stability. When performed by an experienced surgeon, this procedure typically resolves such instabilities, with a reduced risk of further osteodegenerative changes.
The postoperative recovery is relatively long, and it’s important to be guided by an experienced physiotherapist.
If there has been significant damage to the joint cartilage or other knee structures, then the mentioned procedure may not be possible, or a more extensive and complex surgical approach may be required. All details in this regard should be discussed with the surgeon, following a magnetic resonance imaging (MRI) scan, which should provide more detailed information about the condition of the knee.
