Patellofemoral instability

Kneecap dislocations occur when the kneecap is forced out of the groove, usually to the outside of the knee. A first-time dislocation is usually as a result of trauma. However repeated dislocations can occur with less and less trauma. It can be a debilitating condition, both with the event but also the fear that the kneecap can dislocate at any time.

For a patient with a first time dislocation, it is critical to look to any damage to the cartilage as during the dislocation and piece of cartilage and bone may be knocked off during the force of the dislocation. If this is big enough, it can be fixed back, or smaller pieces can be removed from the knee with keyhole surgery. The treatment of first time dislocations is with physiotherapy. The focus will be on core and quadriceps control to reduce putting the knee in positions where it might dislocate. Repeated dislocations that are not controlled with non-operative treatments usually require surgery. There are a number of causes for kneecap dislocations and Mr Smith will assess for these causes as well as perform investigations such as an MRI scan to identify and therefore treat the cause of the dislocations. Kneecap stabilising surgery is usually very successful as stopping further dislocations.

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