Clinical suspicion of patellar dislocation

    The knee is held in 20 to 30 degrees of flexion

    An obvious deformity is typically seen

    Dislocated patella on x-ray (anteroposterior [AP] or sunrise views; lateral view less helpful)

CONTRAINDICATIONS

 Fracture

 Effusion (hemarthrosis)

TECHNIQUE

 Patellar dislocations frequently relocate spontaneously before the patient seeks treatment

 Intravenous Sedation and Muscle Relaxation

    Often the procedure may be accomplished without use of sedation or muscle relaxation

 Reduction Procedure

    Reduction is performed by manually applying pressure to the patella in an anteromedial direction while extending the extremity

       A palpable relocation should be felt and confirmed by relief of the patient’s symptoms

    Reduction may be difficult due to the medial patellar facet being locked on to the lateral femoral condyle

       In these cases, apply downward pressure to the lateral patella which creates the external rotational force needed to unlock the facet (FIGURE 64.1). Continue with the standard reduction technique.

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