A higher-than-normal kneecap after a knee sprain may be the result of a fracture or soft tissue injury. 1. Fracture: A knee sprain may cause a fracture that misaligns the knee joint, causing the knee on the injured side to be higher than the other side. It may also be due to a fracture that creates a localized collection of blood in the tissues (hematoma), causing the knee on the injured side to be higher than the opposite side. 2. Soft tissue damage, edema: Knee sprains are prone to soft tissue damage, including meniscus and ligaments. Conditions such as torn meniscus cartilage or torn ligaments can cause fluid to leak out of the knee joint toward the tear, eventually forming an edema, making the injured knee swollen and higher than the opposite knee. If you experience swelling after a knee sprain, it is recommended that you seek medical attention to determine the cause of the sprain so that treatment is not delayed.