Q. I was playing soccer last week when I twisted my right knee and felt a pop. My kneecap came out of place and then popped back in. My knee swelled and I went to the emergency room, where they took X-rays and told me nothing was fractured. I was given a brace and crutches and then went to an orthopedic doctor. He said I had ligament and cartilage damage and needed surgery. I was nervous and did not get to ask all my questions. Is surgery really necessary, and if so, will I be able to go back to soccer like normal? I am 22.
A. Usually when your kneecap dislocates or “pops out,” you tear a ligament that stabilizes the kneecap in its groove. This is the medial patellafemoral ligament (MPFL). Also, when your kneecap pops out and goes back into place, you get a bone bruise and potentially cartilage damage on the kneecap or the femur, the thighbone.
An MRI scan can be helpful in determining the extent of the damage. About 50 percent of the time, the injury can be treated with just bracing followed by a rehab program. This normally leads to a successful return to play. If significant damage to the cartilage occurred, a piece of bone has been knocked loose, or if the ligament damage resulted in the kneecap not moving correctly in its groove, then surgery is usually necessary. Even if surgery is required, most athletes can return to their sports successfully.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net.