A dislocated kneecap is a frightening and painful injury that raises immediate questions for most people about recovery and long-term outcomes. The good news is that many people can fully recover from a dislocated patella, but your journey depends on several factors, including the severity of injury, anatomical risk factors, treatment approach, and how well you follow your rehabilitation protocols.
Understanding Patellar Dislocation
When the kneecap slips out of its normal groove at the front of the knee, it causes sudden pain, swelling, and difficulty moving. In most cases, the kneecap spontaneously returns to its normal position when the leg is straightened. However, this traumatic event always tears or stretches the medial patellofemoral ligament (MPFL), which serves as the primary restraint preventing the patella from dislocating laterally.
The MPFL attaches the inner edge of the patella to the femur, working like a leash to keep the kneecap on track as you move. When this ligament is injured, the knee becomes vulnerable to future instability.
Recovery Outcomes: What the Research Shows
For First-Time Dislocations
Recovery from a first-time patellar dislocation typically takes six to eight weeks for return to normal daily activities. Most people can participate in sports after three to four months, though this timeline varies based on individual circumstances.
However, the risk of recurrence is significant. Studies show that approximately 33% of patients who experience a first-time patellar dislocation will suffer another dislocation. Some research suggests recurrence rates may be even higher (up to 88%) in certain patient populations.
Conservative Treatment Success
Conservative management, which involves rest, ice, bracing, and physical therapy, remains the first-line treatment for most first-time patellar dislocations without significant bone or cartilage damage.
The treatment protocol typically includes:
- Initial immobilization with a knee brace or stabilizer for a week or so until the leg feels stable.
- Weight-bearing as tolerated, with crutches as needed
- Physical therapy, starting within the first 2 weeks
- Progressive strengthening exercises focused on the quadriceps, particularly the vastus medialis oblique (VMO), along with hip and core strengthening
- Proprioception (your body’s ability to sense its own position and movements in space) and balance training
Early active range of motion and strength training are typically associated with improved knee function, increased range of motion, and higher patient satisfaction compared to prolonged immobilization. Patellar taping and nonrigid bracing can also provide immediate stability and relief while promoting muscle preservation.
Risk Factors Impacting Recovery from a Dislocated Patella
Certain anatomical and demographic factors significantly increase the risk of recurrent dislocation and can affect your ability to fully recover.
High-risk factors include:
- Age: Younger patients, particularly those under 25 with open growth plates, face recurrence rates as high as 60-75%
- Trochlear dysplasia: A shallow groove on the femur that provides inadequate containment for the patella
- Patella alta: A high-riding kneecap that must travel further before engaging in the groove
- Elevated tibial tubercle-trochlear groove (TT-TG) distance: Malalignment that pulls the patella laterally
- Ligamentous laxity: Generalized joint looseness that reduces stability
- Female gender: Women and girls experience higher rates of patellar instability
- History of contralateral dislocation: Previous dislocation of the opposite knee increases risk
When patients have multiple risk factors present, recurrence rates escalate dramatically. Studies show that patients with two risk factors face recurrence rates of 30-60%, while those with three or more risk factors see rates of 70-80%.
Surgical Treatment for Optimal Recovery
When Surgery Is Recommended
Surgery becomes necessary when patients experience:
- Recurrent dislocations or persistent instability after conservative treatment
- Osteochondral fractures (loose bone or cartilage fragments in the joint)
- Severe anatomical risk factors predicting high recurrence
- First-time dislocation in high-risk patients (young age, multiple anatomic abnormalities)
MPFL Reconstruction
MPFL reconstruction has become the primary surgical treatment for patellar instability, with excellent success rates. The procedure involves creating a new ligament using donor tissue or the patient’s own tendon to stabilize the kneecap.
Success Rates:
- 92.8% of patients return to sports after MPFL reconstruction
- 71.3% return to or surpass their preoperative activity level
- Recurrent instability occurs in only 1.8-1.9% of patients
- Overall complication rate is 8.8%
Additional Procedures
Some patients require combined procedures to address multiple anatomical abnormalities:
- Tibial tubercle osteotomy (TTO) realigns the extensor mechanism in cases of elevated TT-TG distance or patella alta
- Trochleoplasty reshapes the femoral groove in severe trochlear dysplasia cases, though this is complex and carries high complication risks and risks damage to the articular cartilage
- Cartilage restoration, which repairs or regenerates damaged cartilage from repeated dislocations
Studies of patella stabilization surgery show that 92% of patients achieve partial to full stability post-surgery, with 48% rating outcomes as excellent and 32% as good. Most patients return to normal activities within weeks, with 80% experiencing no complications.
Maximizing Recovery from a Dislocated Patella
Whether you pursue conservative or surgical treatment, several factors improve your chances of making a full recovery.
Comprehensive Rehabilitation
Physical therapy is essential regardless of treatment approach. A structured program should include:
- Early range of motion exercises to prevent stiffness
- Quadriceps strengthening
- Hip and core strengthening to improve overall lower extremity control
- Proprioceptive training and balance exercises
- Sport-specific drills before returning to athletics
Preventing Patellar Dislocation
To reduce the risk of re-injury:
- Use proper techniques for your sport
- Practice exercises that strengthen and condition your legs
- Follow physical therapy recommendations
- Consider a patellar stabilizing brace during high-risk activities
- Address any anatomical risk factors through appropriate surgical correction
Early Medical Evaluation
If you’ve dislocated your patella, seek immediate medical attention. Your healthcare provider should:
- Perform a thorough physical examination
- Order imaging studies (X-rays and MRI) to assess for osteochondral fractures, ligament damage, and anatomical risk factors
- Develop a treatment plan based on your specific circumstances
An MRI is particularly important (even after a single dislocation) to evaluate the degree of damage and identify likelihood of repeat dislocation. This information guides any treatment decisions and helps predict your outcomes.
Recovering from a Dislocated Patella
You can absolutely recover fully from a dislocated patella, but your success depends on the factors outlined in this post. The key is to recognize risk factors early on, choose appropriate treatment, and dedicate yourself to the rehabilitation process. Whether through conservative management or surgical stabilization, full recovery is an achievable goal for the majority of patients who experience a dislocated patella.
An experienced orthopedic surgeon who specializes in patellofemoral instability can help ensure the best possible outcome and minimize your risk of long-term complications. Have questions? Please reach out.