Diagnosis Explanation:

A patellar dislocation occurs when the kneecap (patella) shifts out of its normal position, usually to the outside of the knee. This often results from a sudden twisting motion, direct trauma, or weak supporting muscles. Symptoms include severe pain, swelling, knee instability, difficulty bending or straightening the leg, and sometimes visible deformity. First-time dislocations may require manual reduction (putting the kneecap back in place), while recurrent dislocations may indicate ligament damage requiring further treatment.

Specific Work Modifications:

• If your job requires standing or walking: Use a brace or crutches (if prescribed) and take frequent seated breaks.
• If your job involves lifting: Avoid sudden knee twisting, deep bending, or heavy loads.
• If your job is desk-based: Keep the knee elevated when sitting and perform gentle mobility exercises.
• Avoid: Squatting, kneeling, prolonged standing, and any activity that increases knee instability.

Specific Activity Modifications:

• If you play sports: Avoid running, jumping, and pivoting for at least 6-8 weeks. Instead, swim or cycle to maintain fitness.
• If you hike: Stick to flat terrain, avoid steep inclines, and use trekking poles for stability.
• If you do weightlifting: Avoid deep squats, lunges, and leg presses until fully healed. Focus on core and hip strengthening.
• Avoid: Cutting movements, sudden direction changes, and high-impact activities until the knee is stable.

Recommended Supplements:

• Collagen Peptides – 10g daily for ligament and cartilage repair.
• Glucosamine & Chondroitin – 1500mg/1200mg daily to support joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin C – 500mg daily to aid collagen production.
• Vitamin D3 + Calcium – 1000 IU/500mg daily for bone strength.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support ligament repair.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep tissues hydrated and support healing.

Home Exercise Prescription (Rehabilitation for Patellar Dislocation)

Early Phase (0-2 Weeks, Reducing Pain & Swelling):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (brace or patellar stabilizer), Elevation.
• Quadriceps Sets – Tighten thigh muscles, hold for 5 seconds, repeat 10 reps, 3x/day.
• Heel Slides – Gently slide heel toward buttocks to maintain mobility, 10 reps, 2x/day.
• Ankle Pumps – Move ankle up and down to improve circulation, 10 reps, 3x/day.

Strengthening Phase (2-6 Weeks, Once Pain Decreases):

• Straight Leg Raises – Keep knee straight, lift leg, hold for 5 seconds, repeat 10 reps, 2x/day.
• Seated Knee Extensions – Slowly extend knee, hold for 5 seconds, repeat 10 reps, 2x/day.
• Glute Bridges – Lie on back, lift hips while keeping knees bent, 10 reps, 2x/day.
• Clamshells (Hip Strengthening) – Lie on your side, open and close knees, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Improving Stability & Return to Activity):

• Mini Squats (No Deep Bending) – Slight knee bends while keeping weight on heels, 10 reps, 2x/day.
• Lateral Band Walks – Step sideways with a resistance band around thighs, 10 steps each way, 2x/day.
• Step-Ups – Step onto a low platform, push through the heel, repeat 10 reps, 2x/day.
• Stationary Cycling – Low resistance for 10-15 minutes/day to improve mobility.

Helpful Books:

1. The Knee Injury Bible: Everything You Need to Know About Knee Pain, Prevention, and Treatment – Kevin R. Stone, MD.
2. Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It – Robert Klapper, MD, and Lynda Huey.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.