Name of the Procedure:

Closed Treatment of Patellar Dislocation; requiring anesthesia
Common name(s): Closed reduction of patellar dislocation

Summary

The closed treatment of a patellar dislocation involves realigning the kneecap (patella) back into its normal position without the need for an incision. The procedure is performed under anesthesia to ensure that the patient does not feel any pain during the process.

Purpose

The procedure addresses patellar dislocation, which occurs when the kneecap slips out of its groove in the thigh bone. The goal is to place the patella back into position, relieve pain, restore normal knee function, and prevent further damage.

Indications

• Acute patellar dislocation
• Knee pain and swelling
• Inability to straighten the leg
• Visible deformity of the knee
• Patients who have experienced their first dislocation or recurrent dislocations

Preparation

• Fasting for a specified period before the procedure
• Adjusting or stopping certain medications as advised by the doctor
• Diagnostic tests such as X-rays or MRI to assess the extent of the dislocation and rule out fractures

Procedure Description

1. The patient is given anesthesia to ensure comfort and painlessness.
2. The healthcare provider gently manipulates the leg, guiding the kneecap back into its correct position.
3. Once the patella is realigned, the leg may be immobilized in a brace or cast to allow the knee to heal.

Tools, Equipment: Anesthesia equipment, immobilization devices (e.g., knee brace or cast)
Anesthesia: General or regional anesthesia

Duration

The procedure typically takes about 15-30 minutes, excluding preparation and recovery time.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon or trained healthcare provider
• Anesthesiologist or nurse anesthetist
• Nursing staff

Risks and Complications

• Pain and swelling
• Recurrence of dislocation
• Damage to ligaments, cartilage, or soft tissues
• Blood clots
• Infection

Management: Monitoring and supportive care, physical therapy, possible follow-up procedures

Benefits

• Relief from pain and swelling
• Restoration of normal knee function
• Reduction of the risk of future dislocations and associated issues
• Improvement in mobility and quality of life

Recovery

• Use of a knee brace or immobilizer
• Instructions on weight-bearing and movement restrictions
• Physical therapy to strengthen the knee and improve range of motion
• Follow-up appointments to monitor healing progression Expected recovery time: Several weeks to months, depending on the extent of the injury and patient's adherence to post-procedure care.

Alternatives

• Surgical intervention if the dislocation is associated with significant damage to ligaments or cartilage
• Physical therapy alone (in minor or non-recurrent cases)
• Lifestyle modifications and bracing for recurrent dislocations

Pros and Cons: Surgery offers a definitive repair but is more invasive; non-surgical options are less invasive but may not be as effective in preventing future dislocations.

Patient Experience

During the procedure: The patient will be under anesthesia and not feel any pain.
After the procedure: Discomfort or soreness around the knee area, which can be managed with pain relief medications and ice packs. Swelling is common and should diminish with time. Patience with gradual physical therapy is required for optimal recovery.