Treatment of Recurrent Subluxation or Dislocation of the Patella

The treatment of patellofemoral joint subluxation depends on the following factors.

  • Degree of lateral displacement of the patella
  • Mechanism or type of subluxation or dislocation-whether it is due to
    • Malalignment of the quadriceps mechanism with contracture of the lateral patellar retinaculum and iliotibial band.
    • Muscle imbalance between a weak and high oblique vastus medialis and a hypertrophied, low, and transverse vastus lateralis
    • Extreme ligamentous hyperlaxity
    • Trauma resulting  weakening of the vastus medialis.
    • Malposition of the patella
    • Angular or rotational deformity of the knee and leg
    • Presence or absence of bony hypoplasia of the lateral femoral condyle.
  • Presence or absence of chondromalacia of the patella.
  • Age
  • Psychological aspects

A rough guide to management of this condition is as follow [Read more...]

Recurrent Momentary Lateral Subluxation of the Tibiofemoral Joint

This entity was first reported by Beals in 1978. In this condition there is  painful, spontaneous, audible popping  of one or both knees. This occurs in infants and children and the causative factor is lateral displacement of the tibiofemoral joint.

It appears to be caused by an isolated contraction of the biceps femoris muscle in association with capsular laxity.

Radiograms in the anteroposterior projection will show lateral subluxation of the tibiofemoral joint.

The proximal tibiofibular articulation is normal.

Treatment

Part-time splinting of the knee in extension will provide symptomatic relief of the painful, irritable knee. A conservative, nonsurgical approach to management should be followed

As the child gets older and the joint capsular hyperlaxity diminishes, the episodes of involuntary subluxation cease.