Name of the Procedure:

Closed treatment of patellar dislocation; without anesthesia
Common name(s): Closed reduction of patellar dislocation

Summary

This procedure involves the manual realignment of a dislocated kneecap (patella) without the use of anesthesia. The goal is to reposition the patella to its normal location within the knee joint.

Purpose

The procedure addresses patellar dislocation, which occurs when the kneecap slips out of its groove at the front of the knee. The goal is to quickly and safely return the kneecap to its correct position to relieve pain, restore function, and prevent further damage to the knee structures.

Indications

• Acute knee pain and deformity suggestive of a dislocated patella
• Inability to extend the knee or bear weight
• Swelling and tenderness around the kneecap
• Patients who have experienced previous dislocations

Preparation

• The patient may need to undergo an X-ray or other imaging studies to confirm the diagnosis of patellar dislocation and rule out fractures.
• No fasting or special preparation is required since anesthesia is not used.
• The patient should inform the healthcare provider of any medications or underlying health conditions.

Procedure Description

1. The patient is positioned comfortably, often lying down with the affected leg slightly bent.
2. The healthcare provider will gently manipulate the kneecap back into its normal alignment, typically by extending the leg and applying pressure.
3. No tools, equipment, or anesthesia are used, making this a purely manual procedure.

Duration

The procedure usually takes a few minutes to complete.

Setting

This procedure is performed in an outpatient clinic, emergency room, or sometimes in a primary care setting.

Personnel

• A physician or trained healthcare provider (e.g., emergency room doctor, orthopedic specialist)
• A nurse or medical assistant may be present for support.

Risks and Complications

• Pain or discomfort during the manipulation
• Swelling and bruising around the knee
• Risk of redislocation
• Rarely, injury to the ligaments or cartilage

Benefits

• Rapid relief of pain and discomfort
• Restoration of normal knee alignment and function
• Immediate improvement without the need for surgery or anesthesia

Recovery

• The patient may need to rest and avoid heavy activities for a few days.
• Cold packs and elevation can help reduce swelling.
• A knee brace or immobilizer may be recommended for additional support.
• Follow-up appointments may be necessary to monitor healing and prevent recurrence.

Alternatives

• Surgical intervention in cases of repeated dislocations or severe damage
• Immobilization alone without manual reduction
• Physical therapy to strengthen surrounding muscles and prevent future dislocations
• Pros and cons: Surgery offers a more permanent solution but involves more risk and longer recovery. Immobilization without reduction may not be as effective in immediate pain relief.

Patient Experience

• The patient might feel discomfort or pain during the realignment process.
• Pain management options may include over-the-counter pain relievers post-procedure.
• Most patients experience immediate relief once the kneecap is back in place, followed by a short period of increased discomfort as the knee heals.