Patellar Stabilizing Procedures

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The patella (kneecap) is a large and critical structure in the front of the knee. It is subject to a great deal of stress, and under certain circumstances, it may be unstable. Surgery is generally only considered in cases where all conservative treatment has failed. Conservative treatment can include ice, compression, bracing, and physical therapy. However, if the patella does not line up properly within the femoral trochlear groove (the groove in front of the femur that guides the patella) and/or the patella that repeatedly dislocates, surgery may be considered.

Surgery
If the initial injury produces a loose piece of bone and cartilage, then treatment will usually include surgery to replace and repair the fracture or, if that is not possible due to the size, nature, and location of the fragment, remove it.

Medial Patella-Femoral Ligament (MPFL) Reconstruction
Medial patella-femoral ligament (MPFL) reconstruction is a procedure used to correct serious and recurring dislocation of the kneecap. The MPFL is the major ligament that stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation. The reconstruction surgery includes using a ligament taken from elsewhere in the body or from a cadaver. The surgeon reconstructs the torn medial patella-femoral ligament to stabilize the kneecap in the trochlear groove, preventing dislocation.

After surgery, patients will complete physical therapy for 3 to 6 months to ensure the muscles are strong and stable. Patients can expect to return to unrestricted activities 6 months to 1 year after surgery.

Tibial Tubercle Osteotomy
Many patients that ultimately need surgery require an open patella realignment surgery. This is called a tibial tubercle osteotomy. The tibial tubercle is where the patellar tendon inserts. Tibial tubercle osteotomy involves cutting the tibia tubercle and shifting it to the middle or front. The tubercle is then held in place with screws. This procedure realigns your patellar so that it sits in the femoral groove. Return to full activity after a tibial tubercle osteotomy is about 4 to 6 months.

To learn more about patellar stabilization procedures, schedule an appointment with one of our joint preservation surgeons by calling 888-660-2663 or complete the appointment request box.

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