Ask Dr. Skendzel: How Are Kneecap Injuries Evaluated?

Sports-related kneecap injuries are common among young athletes. Dr. Skendzel explains when these injuries should be medically evaluated.

Kneecap injury is often overlooked

In the sports media, coverage of ACL and meniscus knee injuries often overshadows news about kneecap injuries. Summit Orthopedics sports medicine surgeon Dr. Jack Skendzel explains why prompt medical treatment is so important for a kneecap injury.

“You don’t have to be an athlete to have an unstable kneecap,” says Dr. Skendzel, “but this is a common sports injury—especially for young athletes playing soccer, football, or hockey. Prompt treatment is important because over time, an untreated damaged kneecap can do serious permanent damage to the knee.”

Understanding the anatomy

The kneecap, or patella, sits in a groove in the femur. A ligament called the medial patellofemoral ligament, or MPFL, holds it in place. The MPFL is located on the inside of the knee and connects the kneecap to the femur or inner thigh bone, helping to keep the kneecap centered in the bone groove. If the MPFL gets torn or stretched, it takes much less force to dislocate the kneecap.

What causes a kneecap injury?

A number of conditions can put stress on the ligament and cause the kneecap to pop out of position.

  • Contact or twist. A direct blow to the knee or a forceful twist or turn can dislocate the kneecap.
  • Loose joints. Some people, and particularly women, tend to have looser joints. Often, their ligaments are also looser, and this combination increases the risk of a kneecap dislocation. Knock-kneed individuals are also at higher risk.
  • A shallow bone groove. In some people, the groove that the kneecap sits in is anatomically more shallow. This makes it easier for the kneecap to pop out.

Symptoms and early evaluation

Symptoms of dislocation are usually apparent. “Often,” says Dr. Skendzel, “you’ll be able to see if the kneecap has popped out. If the dislocation isn’t obvious, be alert to signs like joint swelling or feelings that the knee is unstable.”

If you suspect that you’ve dislocated your kneecap, seek medical care. Unless cartilage has broken off with the dislocation, most first kneecap injuries do not need surgery. But even with a first-time dislocation, it is critical for a Summit sports medicine specialist to assess cartilage damage.

“Our evaluation includes an X-ray and possibly an MRI,” says Dr. Skendzel. “We want to make sure that there’s no damaged cartilage, which can increase the risk of osteoarthritis later.”

Common treatment approach

If cartilage is intact, the normal course of kneecap injury treatment after a first dislocation is conservative. The knee is braced, and the patient is treated with physical therapy and rest for six to eight weeks. “Rest means patients will probably be on crutches for one to two weeks until the swelling goes down,” says Dr. Skendzel. “Then, they’ll walk in the brace, and begin supervised activity with a therapist to work on range of motion and regaining strength. During the rest period, patients can bend their injured knee, but they cannot participate in any athletic activities. Our goal is to help patients regain knee strength and stability. Hopefully, that kneecap will never pop out again.”

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Sports medicine: Expert bone, joint, and muscle care

From Olympians to pro athletes to youth sports and those that just want to be more active – Summit Orthopedics delivers expert care by fellowship-trained sports medicine physicians. If you are recently injured or concerned about ongoing pain, Summit Orthopedics sports medicine specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely help you get back to being active.

Start your journey to a more active self: Find your sports medicine expert, request an appointment online, or call us at 651-968-5201 to schedule a sports medicine consultation.

Summit has convenient locations across the Minneapolis St. Paul metro area, serving Minnesota and Western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as several additional community clinics.

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  • Jack Skendzel, M.D.

    “An active lifestyle requires superior physical function, and I understand that my patients have exceptionally high standards for their performance and joint health. My goal is to return patients to optimal function so that they can continue to perform and master their personal athletic goals.”

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