Unstable knee caps or patellae is a very debilitating condition. There are many reasons this can happen. Some patients have normal knees and anatomy and have an injury that causes their patella to become dislocated. This can damage the medial patello-femoral ligament or MPFL. This can be thought of like a safety rope that protects your knee cap and prevents it from coming out of the trochlear groove where it should run. Once this structure is damaged the knee cap or patella can become chronically unstable and dislocate or sublux. This patellar instability can cause pain and can also cause damage to the articular cartilage. If cartilage is damaged and floats in the knee joint sometimes this can present as locking of the knee. This is an important symptom and something that needs dealt with quickly and may require surgery to reattach the damage cartilage to prevent osteoarthritis developing in the future.
Some patients however are born with abnormal anatomy of their knees and this can develop and cause patellar instability. There are multiple reasons. The trochlea or patellar groove can be too shallow and not capture the knee cap when bending and flexing the knee. The patella or kneecap can be high, called patella alta and this can make it more likely to become unstable and dislocate. Some patients have hyper laxity or ligaments or tendons that are more elastic than normal and therefore the extra freedom of movement often combined with other anatomical issues results in patellar instability and pain.
We can investigate your knees with xrays and MRI scans to see what abnormalities you might have and how best to resolve them to give you pain free and stable knee caps. This patellar stabilisation surgery ranges from physio and advice up to MPFL reconstruction, tibial tubercle osteotomy or trochleoplasty surgery. It is important when seeing someone for a consultation for patellar instability that they have the full range of skills and techniques to solve your problem. As a pure knee surgeon Mr. Frame has those skills and has spent time with the world expert Dr. David Dejour in Lyon France learning how to approach, diagnose and solve the complex issue that is patellar instability.
If you have had problems in the past with patellar instability and this was not treated and you now have pain and osteoarthritis affecting your knee caps and you have been told you need a total knee replacement, it might be possible to simply have your kneecap and patellar groove resurfaced with a partial resurfacing of your patellofemoral joint. Get in touch now to have a consultation where we can help you will all aspects of your knee pain or problems.