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• Q: Why does my kneecap keep dislocating, and what treatment is available?
Dr. Vic Ayers, Orthopedic Surgeon & Maui Memorial Chief of Staff, Pacific Permanente Group: Patella dislocation occurs when the patella, or kneecap, pops out of the groove that holds it in place at the knee joint. This usually occurs as a result of impact or injury, often while engaging in sports or other physical activity. Teenagers are often at higher risk because their joints are still growing.
A patella dislocation is usually very painful. Once the kneecap pops out it locks the knee, and you're unable to bear weight or walk on the injured leg. The dislocation can also cause damage to surrounding ligaments, tendons and cartilage.
Sometimes the kneecap will pop back into place on its own when the leg is extended. Otherwise, a trained health care provider can maneuver the patella back into place, either on the sports field or in an emergency room.
However, if imaging tests show that the dislocation caused more extensive injuries to tissues inside the knee, you may need surgery to repair the damage. Physical therapy and rehabilitation can also help the knee to heal.
We know that once you've had a patella dislocation, you're more likely to have it again. If you've dislocated your kneecap multiple times, your doctor may recommend surgery to repair the internal structures to better support and stabilize the knee.
In addition to surgery, you can help reduce your risk of future dislocations by giving the knee time to fully heal before resuming sports, and completing all physical therapy and rehabilitation exercises as prescribed. Strengthening your leg muscles, and stretching the leg with the help of a trainer or physical therapist can also help stabilize the joint. Finally, working with an expert to check and improve your athletic form or movements can also help you avoid reinjuring the knee after it heals.
The orthopedic specialists at Maui Memorial Medical Center Outpatient Clinic offer exceptional orthopedic care, with a large team of specialists, including board-certified surgeons and clinical staff. They treat a range of sports injuries and joint problems, including patella dislocation. Learn more or make an appointment at mauihealth.org/ortho.
• Q: Does spinal cord injury always cause paralysis?
Jeffrey Later, RN, Trauma Program Supervisor, Maui Health: Spinal cord injuries can be classified into two types: complete or incomplete. A complete injury means the body is paralyzed and has lost all function below the injured area. An incomplete injury means some movement or sensation may remain.
Complete spinal cord injuries are usually permanent. However, some people with incomplete injuries may recover some function or sensation over time.
Spinal cord injuries are usually caused by some kind of trauma, like a car accident or fall, that causes damage to the vertebrae, ligaments or disks in the spine. Unlike a back injury, which can involve damage to the bones or tissues of the spine, a spinal cord injury causes damage to the spinal cord itself.
Symptoms of a spinal cord injury include loss of movement or sensation, spasms and pain. If someone has extreme pain or pressure in the neck or back after an accident, weakness or paralysis, numbness or tingling, difficulty breathing, loss of bowel or bladder control, or a visibly broken or twisted neck or back, those are signs that the person needs emergency care. Keep the person still, do not move the head and neck, and call 911.
Maui Memorial Medical Center is a Hawaii State Level III Trauma Center, with trauma surgeons available 24/7 to provide the highest level of trauma care, as well as specialists including neurosurgeons capable of treating spinal cord injuries. For more information about Maui's trauma services, visit mauihealth.org/trauma.
* Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana'i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.