Treatments for Patellar instability in Children

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Treatment for kneecap dislocation depends on how serious the injury is, and whether the kneecap will continue to stay in place over time.

  • The goal is to bring the kneecap to its proper place and keep it there.
  • Most of the time, the kneecap will go back into place on its own immediately after it dislocates.
  • Sometimes, the doctor might have to sedate the child so he can use more force to get the kneecap back into place.
  • After the kneecap is back in place, a supportive brace and physical therapy may be enough to fix the problem.
  • Other times, children need surgery to keep the kneecap in place. Both treatment options usually allow the child to return to sports and other activities in three to four months.

 There are two ways that children can be treated for kneecap dislocation: 

Treatment without surgery

  • If your child's kneecap dislocates during an accident, he should go to the emergency room. Here, the doctor will do an X-ray to see if the kneecap is back in place. Most of the time it will be back in place. 
  • If it is still out of place, the doctor might be able to do place it back in its groove easily, with very little pain, but if it seems more complicated, then he may sedate your child and use more force to get it back in place.
  • After the kneecap is back in place, your child will wear a knee immobilizer, which is a tight but comfortable support placed around the knee to keep it straight.
  • For the next two weeks, he can walk around using the knee immobilizer and crutches, and should go back to the doctor for a check-up.
  • The doctor will look at the knee again, and might give him a more flexible brace that lets the knee bend more, and become stronger.
  • If the kneecap continues to slide out of place, your doctor may do an MRI to check for any tears in the ligament or loose pieces of bone that might have broken off during the dislocation. 
     

Surgical treatment

  • If an MRI shows loose cartilage or bone, or tears in the ligaments, your child might need surgery to tighten the ligaments and make the area around the knee stronger.
  • After surgery, your child will probably wear a brace and walk with crutches for six weeks, and go to physical therapy for two to three months.
  • Once the pain and injury are gone, children usually can return to sports.


Coping and support 

At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. If your child is admitted to the hospital for an extended stay, or needs more extensive care, your family may want to take advantage of the Center for Families, which can help connect you with resources, should you need them: 

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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