Surgical treatment of patella dislocation

The knee joint is the largest joint in the human body. It is a complex joint connecting the femur and the tibia. The joint is formed by the patella which, together with the tendon and quadriceps of the thigh and the patella ligament, forms the upright apparatus of the knee joint.

A patella dislocation is an injury where it slips out of the intercondylar notch. In colloquial terms, the patella ‘pops’ completely out of the groove on the femur in which it moves. It may return to its position on its own, but sometimes it needs to be adjusted by a doctor.

The first dislocations of the patella usually occur around the age of 15 and are more common in girls than boys. This is usually caused by a minor injury, where the child feels a sudden, very painful click in the joint when jumping, pivoting on the leg or even when sitting down. Sometimes a dislocation occurs when the knee is hit, for example during sports activities.

The most common cause of dislocations is a malformation of the knee joint, which develops during a child’s growth and can be inherited from parents and also occur in siblings.

After the first dislocation, the injury is usually treated conservatively, as the risk of a second dislocation is only about 15%. 15 %. With a second dislocation, the risk increases to 90 % and surgery should be considered here.

Surgical procedures can be divided into those that correct soft tissue disorders and those that correct bone disorders. The surgical decision is based on a discussion with the patient, an examination of the joint, an ultrasound and a CT or MRI scan of the joint. The most common procedure is a reconstruction of the patellar-femoral ligament, which stabilises the patella. The procedure is done on an outpatient basis. You will have to walk on crutches for about 2 weeks.

It takes about 4-6 weeks to return to normal function, and 6 weeks to return to sport activity.

Rehabilitation
After surgical treatment, it is important to introduce targeted rehabilitation as soon as possible. In the first few days after the surgery, the knee should be actively flexed and straightened with as much range of motion as possible, up to the pain threshold. In addition, it is advisable to mobilise the patella to prevent adhesions forming around it, and to do isometric and strengthening exercises for the anterior thigh muscle group and other stabilisers of the knee joint.