How is patella instability treated?
On occasion, the kneecap will not go back into place if it is dislocated. If this happens, it is important to seek prompt medical care to reduce (put back into place) the patella.
Most first time patella dislocations can be treated non-operatively. The exception is patients who have also developed a loose body or cartilage injury. In these cases, surgery will be needed to remove the loose body, potentially repair the cartilage damage and restore the stability to the patella.
Depending on the severity of the patella dislocation, Dr. Vidal may prescribe a knee brace and crutches. After a period of rest, he will have the patient begin physical therapy to strengthen the muscles in the knee that will improve knee stability.
Patients who have recurrent patella instability, or who have recurrent knee dislocations, may require surgery to restore the ligaments that help stabilize the knee. Surgery for patella instability is very individualized and Dr. Vidal will assess the patient for underlying risk factors for future instability. He may recommend a soft tissue procedure, where the torn or stretched medial patellofemoral ligament is repaired or more frequently, reconstructed.
A bony procedure may be recommended if the patient has an abnormality in which the patella tendon causes misalignment with the tibia in such a way that the kneecap is pulled sideways. For this procedure, Dr. Vidal removes a small portion of bone where the tendon attaches and repositions it, allowing the tendon to guide the patella effectively into the trochlear groove. This surgery is called a tibial tubercle osteotomy or transfer.