Background
“Knee-cap” or patella instability is a common of cause of knee pain that impacts on a person’s performance and activities. There are a number of factors that can predispose to patella instability ranging from normal anatomical variants to injury/trauma. Patella problems exist along a spectrum ranging from patella maltracking to recurrent dislocations. Most patients describe a sense of apprehension during daily activities which is often exacerbated with more vigorous pursuits including sport.
Indications
Anatomical variations predisposing to patella maltracking manifest as pain and mechanical symptoms. If left untreated this can result in accelerated knee arthritis and decreased function. More extreme forms can result in patella subluxation or even dislocation. A patella dislocation will usually result in a very swollen knee which will take some weeks to settle down. Subsequent to this the patella is more prone to future dislocations or instability.
Treatment/Pathology
Depending on the cause of your patella instability (anatomy/physiology versus trauma/injury) there are specific treatments aimed at restoring stability to your knee. Most patients have previously trialed and subsequently failed forms of non-operative management (e.g. strapping, bracing) and are seeking a surgical solution to their problem.
Dr Bartlett will carefully examine your knee and lower limb alignment to determine the underlying cause of your patella instability/maltracking and in most cases will refer you for relevant imaging to help plan your management.
Surgical Detail
Patella realignment/stabilization is aimed at restoring the normal movement of the knee joint and allows you to return to your activities/pursuits. This surgery is performed under general anaesthetic via small incisions around the knee based on the pathology that is being treated. The knee is normally immobilized in a brace or splint to help protect the repair.
Post-Operative/Recovery
Patients typically spend one night in hospital to monitor their pain and swelling. A physiotherapist will meet you the following day to commence your rehabilitation before being reviewed for discharge by Dr Bartlett. Your 2-week review includes a wound check and a chance to monitor your recovery.
Key Points
Debilitating knee pain
Subluxation/Dislocation
Malalignment versus Injury