There are three types of patella dislocation: acute, recurrent, and habitual. Acute dislocation occurs suddenly due to quadriceps contraction with the knee flexed and results in the patella dislocating laterally, causing pain, swelling, and inability to straighten the knee. Recurrent dislocations are caused by ligament laxity or anatomical abnormalities and damage bones with repeated dislocations. Habitual dislocations occur every time the knee is flexed and present in early childhood.

1. Dislocation Of Patella.

4. Types Acute Recurrent Habitual

6. 1. Acute Result 4m sudden contraction of quadriceps while the knee is flexed or semi-flexed. Dislocates laterally C/F: Pain Swelling Unable to straighten the knee Medial condyle(Femur)  more prominent Tenderness (antero-medially)

7. Treatment: Reduction- Under Gen. anesthesia Immobilisation: cylinder cast—3 weeks

8. Recurrent D/L Etiology: Congenital Lig. Laxity hypoplasia of lat. Femoral condyle Flattening of Intercondylar groove Patellar maldevelopment Primary muscle defect Genu valgum Acquired Genu valgum Inequality of growth of condyle Weakness of Quads Contracture fibrosis

11. Pathology First episode Tear of capsule on medial side of patella If improper healing Persistent laxity Recurrent d/l Damage to contiguous surface of patella & fem. Condyles Flattening & then further d/l

12. C/F More common in girls Often B/L Acute pain with knee stuck in flexion In dislocated state: Visually obvious Tenderness Swelling Between attack Patella alta Gen. lig. Laxity Apprehension test +ve

13. Investigation: X-ray Dislocation High-riding patella Other anatomical abnormality MRI CT-SCAN

18. Treatment Conservative Quads exercise NSAIDS Operative Camphell Op. Goldwait op. Hauser’s op. Patellectomy Muscle release with V-Y Z-plasty

22. Habitual D/l Everytime knee is flexed, It dislocates laterally Present in early childhood

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