Prepatellar Bursitis post patellar luxation

Patient

Q: Hi im 19 year old female 5 months ago i dislocated my patella from kneeling i attended emergancy department were i had xays and a MRI scan. I was told blood had got trapped from dislocating it and i had tilted knee caps and was reffered to physiotherpy. After all these months its still swollen and very painfull and clicks when its bend or straighted is this normal will the blood just go away thats trapped? its ruining my life been off work sinice cant walk far or do everyday things

Doctor

A:   Eventually the blood and or liquid collected will be reabsorbed, but if this does not happen after a while and is producing pressure it might need to be drained in order to relieve that pressure from the knee. Most likely you had a liquid collection in your prepatellar bursa produced by the previous traumatism (patella luxation).The prepatellar bursa is a superficial bursa with a thin synovial lining located between the skin and the patella. Normally, it does not communicate with the joint space and contains a minimal amount of fluid; however, inflammation of the prepatellar bursa results in marked increase of fluid within its space. The recommended treatment would be: after the initial period of rest, physical therapy is started to regain any loss of Range Of Motion, while increasing the flexibility and strength of the quadriceps and hamstrings. Your PT should emphasize postural education on the avoidance of painful movements, especially kneeling, and use of kneepads if kneeling is necessary. The traumatic patellar dislocations affect mainly adolescents and young adults. Research studies show that up to 44% of patients will develop recurrent dislocation. If the patella dislocate multiple times the surgical correction has to be considered in order to stabilize the patella and avoid the risk of osteoarthritis secondary to repeated articular.

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