Patella Stabilisation Surgery
Patellofemoral instability
The patella (kneecap), normally glides within a groove (trochlea) in the femur (thighbone) at the knee joint, stabilised by the anatomy of the bone and supportive ligaments (MPFL- Medial Patellofemoral Ligament). Patients with patella instability suffer from painful dislocations of the kneecap in day to day life or during sporting activities.
Patella dislocations can result from a direct blow to the kneecap or be associated with knee movements with no trauma involved. Predisposing anatomical (leg alignment- valgus or knock knees, femoral anteversion or intoeing, patella alta or trochlea dysplasia) or physiological (ligamentous laxity- "double jointed") factors may be involved.
Treatments for patellofemoral instability
Non-surgical treatment is currently the first-line treatment for patella dislocations. A targeted physiotherapy program is successful in preventing future dislocations and allowing return to full activity in the majority of patients.
Surgical treatment is recommended for those individuals who have recurrent patella dislocation. Treatment is individualised as each patient may require correction of different predisposing factors. Surgical options include one or a combination of:
- Medial Patellofemoral Ligament Reconstruction: In this procedure, the torn MPFL is removed and reconstructed using a hamstring tendon graft taken from the same individuals (autograft) or from a donor (allograft).
- Tibial Tubercle Realignment or transfer: Tibial Tubercle Osteotomy surgery is performed by moving the bone at the insertion point of the patella tendon and re-aligning it in a new position with screws to stabilise the bone.
- De-rotation osteotomies, guided growth modulation or deformity correction: To correct abnormal leg alignment that significantly contributes to patella dislocation.
