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Patella subluxation or dislocation (i.e. kneecap dislocation) commonly occurs in an athletic population. Surgical stabilization is occasionally required after initial injury and more commonly performed following recurrent knee instability events.
Optimal patellofemoral (i.e. kneecap) joint function is critically important for active patients engaging in recreational and/or elite level athletics. An unstable patella causes symptoms of instability, pain, and reduced function. This can also lead to progressive damage to knee joint cartilage surfaces over time.
Following patella dislocation, patients are evaluated in the clinic and appropriate images (i.e. x-ray, MRI) are obtained. Non-surgical treatment is often attempted for first time patella dislocations. Surgical stabilization is offered in cases of recurrent instability and, rarely, in higher risk patients after their initial episode.
Patella stabilization surgery is individualized based on patient factors and their underlying kneecap joint alignment. Medial patellofemoral ligament reconstruction (i.e. MPFL) is the gold standard procedure for soft tissue stabilization. In select higher risk patients, additional bony procedures (i.e tibial tubercle osteotomy, trochleoplasty, rotational osteotomy) and/or cartilage restoration (ie MACI, osteochondral allograft) may be performed. The majority of these procedures are outpatient or short overnight stay. Patients should expect an initial period of protection using crutches/brace. Post-op rehabilitation is performed 2-3X/week for several months. Return to activity and sport is INDIVIDUALIZED and is based on both minimum time from surgery and, more importantly, functional progression with rehabilitation.
Tibial Tubercle Osteotomy
Dr. Sherman at The 2nd British Patellofemoral Society Annual Meeting
“I want to give a big shout out to Dr. Seth Sherman. I have my 1-year post-op appointment on October 4th (literally, my 1-year anniversary). Dr. Sherman gave me my life back by performing a very rare knee surgery on me. Without him and his knowledge and wonderful team, I would still be lacking a life without any type of activity.” – Whitney
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