Occasionally, the kneecap can become unstable and dislocate or slide out of the groove that it normally glides through.
This often injures the primary stabiliser of the kneecap, the medial patellofemoral ligament (MPFL). Usually this is treated non-operatively with physiotherapy to strengthen the quadriceps muscles, in particular the VMO. However, some patients suffer from recurrent dislocations despite conservative management and may require surgery.Â
MPFL reconstruction is the most common surgery performed for recurrent dislocation of the kneecap. This usually involves taking a graft (normally hamstring) from the patient to substitute the reconstruct the ligament. This graft is fixed between the inner kneecap and thighbone to restore stability.
Sometimes a tibial tubercle osteotomy (TTO) is performed in addition to an MPFL reconstruction. This involves realigning the attachment of the patellar tendon through bony cuts to reduce the chances of the kneecap dislocating.
Additional procedures including keyhole surgery to tidy up any cartilage issues are often performed at the same time.
