Patella Stabilisation
What is Patella Stabilization?
Patella stabilization, also known as patella realignment, is a surgical technique used to stabilize recurrent patellar (knee cap) instability. Patellar instability is a condition characterized by damage to the supporting ligaments that may cause the patella to slip out of its groove either partially (subluxation), or completely (dislocation).
Anatomy of the Patella
The patella, also known as the kneecap, is a small disc of bone that rests on a groove on the front side of the femoral bone. The patella, along with the lower end of the thigh bone (femur) and the upper end of the shin bone (tibia), make up the knee joint. The patella is located in the quadriceps tendon at the front part of the knee and acts as a pulley that helps in knee movement.
During vigorous physical activity such as high-impact sports, the kneecap may pop out of the groove leading to patellar subluxation or dislocation. This can lead to cartilage damage and impaired knee function if not treated.
Preparation for Patellar Stabilization
Your doctor will perform a physical examination and recommend certain diagnostic procedures like X-ray and CT scanning to assess the condition of the patella and determine the degree of dislocation. You should inform your doctor of your past medical history, daily medication regimen, and history of allergies prior to the procedure. You should also refrain from smoking as it slows down the healing process.
Procedure of Patella Stabilization
On the day of the surgery, your doctor will mark the incision site on the limb. This surgery is usually performed under general anesthesia via a minimally invasive arthroscopic technique. Some of the common surgical procedures that may be performed include:
- Medial Patellofemoral Ligament Reconstruction: In this technique, the damaged medial patellofemoral ligament (MPFL) is removed and reconstructed using a graft taken from the hamstring tendons that is fixed to the patella tendon using screws. The graft is either taken from your own body (autograft) or from a donor (allograft).
- Trochleoplasty: This technique involves lengthening the walls of the trochlear groove or removing any abnormal bony growths, which helps to deepen the groove and provide stability.
- Tibial Tuberosity Osteotomy: This technique involves performing a small incision near the tibial tuberosity. Using a special saw, some of the bone is removed which helps to fix the kneecap in its proper position in the groove. Once the kneecap is in position, the bones are fixed using screws.
Post-procedural Care and Recovery for Patella Stabilization
After surgery, your doctor will recommend using crutches or a walker to avoid bearing weight on the treated knee. For the first 3-6 weeks, you will have to wear a brace to support the knee. Your doctor will prescribe pain-relief medications and physiotherapy to strengthen joints and increase mobility. Avoid strenuous activities and bearing heavy weights until cleared to do so by your doctor.
Risks and Complications of Patella Stabilization
Some common risks and complications of patella stabilization include the following:
- Nerve damage
- Blood clots
- Infection
- Stiffness
- Recurring dislocation
