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Kneecap Dislocation in Children and Teens
Patellar instability in children and adolescents occurs when the kneecap (patella) slides out of position, usually to the outside of the knee - it most commonly affects teenage girls during sports involving pivoting or cutting movements - first-time dislocations are typically treated non-surgically with bracing and physiotherapy (60-70% avoid recurrence), while recurrent instability often requires surgery to reconstruct the ligament holding the kneecap in place (MPFL reconstruction) or realign knee structures, achieving 85-90% stability after surgery.
đWhat is Kneecap Dislocation in Children and Teens?
Patellar instability in children and adolescents occurs when the kneecap (patella) slides out of position, usually to the outside of the knee - it most commonly affects teenage girls during sports involving pivoting or cutting movements - first-time dislocations are typically treated non-surgically with bracing and physiotherapy (60-70% avoid recurrence), while recurrent instability often requires surgery to reconstruct the ligament holding the kneecap in place (MPFL reconstruction) or realign knee structures, achieving 85-90% stability after surgery.
đŦWhat Causes It?
- Direct blow to kneecap during contact sports knocking it out of position
- Twisting or pivoting movement with foot planted causing kneecap to slip laterally
- Shallow groove in thighbone (trochlear dysplasia) failing to hold kneecap in place
- Torn MPFL ligament (medial patellofemoral ligament) that normally prevents lateral dislocation
- Anatomic variations: high-riding kneecap (patella alta), knock knees, rotated shin bone
â ī¸Risk Factors
You may be at higher risk if:
- Female gender (2-3 times more common than males due to wider pelvis and knee alignment)
- Age 10-17 years (peak incidence during adolescent growth spurt)
- Sports with cutting, pivoting, jumping (basketball, soccer, gymnastics, dancing)
- Anatomic risk factors: shallow trochlear groove, patella alta, increased TT-TG distance
- Generalized joint laxity or hypermobility (loose ligaments throughout body)
- Family history of patellar instability
đĄī¸Prevention
- âStrengthen quadriceps muscles (especially VMO) with physiotherapy exercises
- âUse proper landing technique in jumping sports (avoid knee valgus - knees collapsing inward)
- âAddress generalized hypermobility with strengthening program if loose ligaments
- âConsider activity modification if multiple dislocations (avoid high-risk pivoting sports)
- âWear patellar stabilizing brace during sports after first dislocation (may reduce recurrence risk)