When patients develop instability of their patella and dislocations or subluxations occur, then Patella reconstruction surgery is often recommended.
After the first dislocation, conservative management, physiotherapy
The vast majority of the time reconstruction of the medial patellofemoral ligament creates sufficient stability for most patients. This surgery has evolved in the last 10 years and has largely replaced the tibial tubercle osteotomy. Some patients do still require tibial tubercle osteotomy but this is a more invasive procedure than the medial patellofemoral ligament reconstruction which is done with small incisions and is less difficult for patients to recover from.
During the medial patellofemoral ligament reconstruction surgery the gracilis hamstring tendon is used as a restraint or check reign on the inner edge of the kneecap to stabilise the kneecap and prevent it from dislocating. The patient is allowed to weight bear as tolerated immediately on the leg and physiotherapy can start promptly.
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