The patella, or kneecap, is a disc of bone that sits on the front of your knee suspended between the thigh and shin bones by tendons. The kneecap comes under a lot of stress and also protects the knee joint by acting as a physical shield so damage to the kneecap itself isn’t uncommon. We can treat patella problems in Sheffield, Rotherham, Doncaster and Worksop.
Within the knee joint, there are three cushioning fat pads. When a fat pad becomes pinched by the bones of the joint, such as the patella and femur, it’s called an impingement. Fat pad impingement can occur as a result of an injury or gradually over time if the leg is frequently over-extended.
The fat pads have a lot of nerve endings so impingement can be very painful. The pain is located at the front of the knee below the patella and is worse when going up or downstairs, standing or repeatedly bending your knee.
Treatments include rest, pain management and strengthening exercises. Physiotherapy may include taping your knee to relieve the pressure on the fat pads and learning how to avoid overextending your leg. Surgery isn’t common for fat pad impingement but may be an option if other treatments have failed.
Patella tendinopathy is pain in the tendons that connects the patella to the leg bones. Injuries can occur to the patella tendon which connects the kneecap to the lower leg, sometimes called Jumper’s Knee. Injuries to the quadriceps tendons, which connect the large thigh muscles to the kneecap, are more common in older people. Injuries can occur due to overloading these tendons, such as playing sport or from the ageing process. The tendons may become inflamed or develop several tiny tears. Also, a partial or full tear can occur.
With patella tendon injuries, pain and swelling are usually localised to the tendon that is damaged, for example, below the knee for a patella tendon injury. A partial tear will affect your ability to walk and a full tear will make your knee impossible.
Minor patella tendinopathy can be treated with rest, to allow the inflammation to subside, followed by physiotherapy. Full tears will likely require surgery to reattach the severed tissue.
The patella normal sits in a groove in the bottom of the thigh bone where it glides over the joint when bending the knee. Kneecap dislocation is where the patella becomes dislodged usually to the outside of the knee. A dislocated kneecap can cause damage to the tendons and ligaments of the knee joint. This can overstretch the tendons and ligaments making another kneecap dislocation more likely. Multiple dislocated kneecaps are called kneecap instability. A dislocated knee is where the lower leg becomes dislocated.
Dislocation of the kneecap can be caused by:
A dislocated kneecap will look deformed, give severe pain and leave you unable to walk. Dislocations are considered a medical emergency and need immediate medical treatment. The quicker the kneecap can be put back into the correct alignment, the better your recovery will be.
Any dislocation will require physiotherapy during recovery with the objective of recovering a full range of movement and strengthening the soft tissue in a hope to prevent further dislocations. You will probably use crutches or a knee brace to walk and need to take medication for the pain. For kneecap instability or recurring dislocations, surgery can tighten the soft tissues around the kneecap to help prevent further dislocations.
The kneecap can become fractured, usually as a result of trauma to the knee from a sports injury or even a car accident. Fractures range from hairline fractures that remain aligned and ready to heal to open fractures where the broken bones of the kneecap protrude through the skin.
Fractures are painful and will affect your ability to move your leg or walk. Recovering from a fracture may require a leg cast or brace, depending on the type of fracture. Surgery can also be used to remove any loose bone or stabilise the pieces of bone.