Trauma & Sports

    Patellar Dislocation

    Kneecap dislocation in children: evaluation, conservative and surgical treatment.

    Medically reviewed: April 2026·Dott. Daniele Priano

    Quick Answers

    After a patellar dislocation, can it happen again?
    Yes, it can. The risk of a further episode rises after a second dislocation and in the presence of predisposing anatomical factors (ligamentous laxity, trochlear or patellar shape), but these figures describe group tendencies and cannot reliably predict what will happen in an individual child. This is why rehabilitation after the first episode, focused on the whole quadriceps and hip musculature and on neuromuscular control, is important.
    Does my child need surgery after a dislocation?
    Not always. The first episode is generally treated conservatively (brace + physical therapy) with excellent results. Surgery is considered for: recurrent dislocations, associated injuries (osteochondral fragments), or severe predisposing anatomical factors.
    See all 7 questions →

    Patellar dislocation occurs when the kneecap slips out — almost always laterally — from its natural gliding groove. In children and adolescents it is a relatively frequent event, especially in those who play sports involving sudden changes of direction, and more often affects girls during the pubertal phase.

    The episode typically happens during a knee rotation movement or after direct trauma. Pain is acute, the knee swells rapidly, and there may remain a sensation that "something has gone out of place". Sometimes the patella reduces spontaneously; in other cases a reduction maneuver in a clinical setting is required.

    Evaluation after the first episode is important to identify predisposing factors (ligamentous laxity, anatomical features of the lower limb, shape of the patella and femoral trochlea) and to estimate the risk of new episodes. On this basis we build a personalized path together with the family: in most cases the first episode is managed conservatively with a targeted rehabilitation program, while in recurrent forms or with significant risk factors a surgical option is considered.

    Assessment and treatment

    When to seek evaluation

    • First episode of patellar dislocation (always specialist evaluation)
    • Recurrent dislocations (more than one episode)
    • Sensation of knee instability
    • Persistent swelling after trauma
    • Family history of patellar dislocation
    • Associated anterior knee pain

    What is evaluated

    • History of traumatic event and any previous episodes
    • Clinical assessment of patellar stability (apprehension test)
    • Lower limb alignment evaluation
    • General ligamentous laxity (Beighton score)
    • Knee X-rays (standard views + patellar axial)
    • MRI, mainly when an osteochondral lesion is suspected or to plan treatment — not a routine step for every first episode

    Treatment options

    • Conservative treatment: brace, ice, physiotherapy for global quadriceps recovery
    • Rehabilitation program focused on hip strength, neuromuscular control, proprioception and movement quality
    • Proprioceptive taping during sports
    • Medial patellofemoral ligament reconstruction (MPFL) for recurrences
    • Surgical correction of predisposing factors in selected cases

    Frequently Asked Questions

    After a patellar dislocation, can it happen again?▼
    Yes, it can. The risk of a further episode rises after a second dislocation and in the presence of predisposing anatomical factors (ligamentous laxity, trochlear or patellar shape), but these figures describe group tendencies and cannot reliably predict what will happen in an individual child. This is why rehabilitation after the first episode, focused on the whole quadriceps and hip musculature and on neuromuscular control, is important.
    Does my child need surgery after a dislocation?▼
    Not always. The first episode is generally treated conservatively (brace + physical therapy) with excellent results. Surgery is considered for: recurrent dislocations, associated injuries (osteochondral fragments), or severe predisposing anatomical factors.
    How long until return to sports?▼
    After a conservative path, return to sports usually occurs over a few months, when the stabilizing musculature has sufficiently recovered. After surgery, recovery is longer to allow healing of the reconstructed structures. The return is gradual and guided by clinical progress, not a fixed calendar.
    What can I do to prevent recurrences?▼
    Prevention relies on: targeted work on the knee stabilizing musculature, proprioception and neuromuscular control exercises, attention to sudden rotational movements, possible support of braces or knee sleeves during sports activity in the recovery phases. Consistency of the rehabilitation program is the most important factor.
    After dislocation the knee is swollen: is it normal?▼
    Yes, swelling (joint effusion) is an expected reaction after a dislocation episode, because small injuries to the patellar stabilizing tissues can occur. Swelling decreases in the following days with rest, ice and load management. An effusion that persists or recurs requires evaluation to rule out associated injuries.
    Are there factors that predispose to dislocation?▼
    Yes, the most common are generalized ligamentous laxity, peculiarities of lower limb anatomy, conformation of the patella and femoral trochlea and, sometimes, family history. Identifying them during evaluation is important because it guides the path and allows more accurate estimation of recurrence risk.
    Can my child keep playing their sport?▼
    In most cases yes, especially after a good rehabilitation path. The choice depends on the type of sport (sports with cuts and contact are more demanding), the number of episodes and the presence of risk factors. The decision is made together, weighing risks, benefits and the young person's motivation.

    Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.

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