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Patella Instability/ Patella Dislocation

Dr Dan offers a menu à la carte approach to Patella instability and dislocations

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Click here for a generic patient information regarding Patella Instability

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Medial patellofemoral ligament reconstruction

MPFL reconstruction

For the knee cap to dislocate, the medial patellofemoral ligament(MPFL) must rupture. Surgical management revolves around successfully reconstructing the MPFL as it is the primary stabiliser of the knee cap during early flexion.

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Dr Dan performs the reconstruction using minimally invasive technique.

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However if there if abnormal anatomy, this also needs to be addressed in a a la carte approach,to achieve the best functional outcome and decrease the chance of the patella dislocating again.

Trochleoplasty

Open trochleoplasty/ arthroscopic trochleoplasty/ trochlear dysplasia

The trochlea is the groove within the femur which the knee cap/patella articulates with during knee flexion.

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In people with patellar instability the trochlea is flat, or even convex compared to it's normal concave shape. This is called trochlear dysplasia (picture on the right).

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A trochleoplasty is a surgical procedure to re shape the dysplastic(abnormal) trochlea back to it's normal shape

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Dr Dan learnt the the thick flap Lyon/Dejour trochleoplasty from Dr David Dejour, and also the arthroscopic thin flap/Bereiter trochleoplasty  from it's inventor, Dr Lars Blond.

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Depending on your type of trochlea dysplasia and associated anatomy Dr Dan can offer you a trochleoplasty best suited to you.

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Tibial Tubercle Osteotomy

TTO

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The tibial tubercle is where the patella tendon/ligament inserts.

 

By modifying the position of the tibial tubercle, the knee cap/patella position can be changed, improving patella tracking, offloading certain areas of the cartilage and forces in the patellar tendon can be manipulated, making it a useful surgery for patella dislocations, pain and tendinopathy. 

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Severe rotation/torsion- On the left the feet face forward but the knee cap faces excessively inward, on the right with the knee cap facing forward, the feet face excessively outward/sideways.

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