High Tibial Osteotomy

What is Recurrent Patellar Dislocation?

Patellar dislocation is the outward displacement of the knee cap (Patella) from its location. If it happens repeatedly it is termed as recurrent.

What are the causes of Recurrent patellar dislocation?

The Patello femoral joint unlike the hip joint is a shallow joint & the patella is kept in place with the help of surrounding bony contours & various ligaments & tendons. Any abnormality in the bony contour since birth leads to mal-tracking (improper movement) of the patella which eventually leads to dislocation. Once a dislocation happens it leads to tear of the Medial Patellofemoral Ligament (MPFL) which is the most important inner stabilizer of the patella. It doesn’t heal back properly after the tear & leads to repeated (recurrent) dislocation of the patella.

How to find the exact cause of recurrent patellar dislocation?

Evaluating a recurrent patellar dislocation is challenging because there could be multiple factors affecting the tracking of the patella in that particular person & even if one factor is left behind the could be recurrence of the dislocation even after surgery. The most common issue some abnormality in the bony contour leading to outward deviation & subsequent dislocation. Other causes are knock knees, intoeing, tight bands on outer aspect of the thigh & lastly a traumatic dislocation of a normal patella which is improperly treated leading to subsequent dislocations

A thorough examination followed by series of tests like Xrays, CT scan & an MRI gives a conclusive diagnosis of the cause of dislocation

How is Recurrent Patellar dislocation managed?

Just after the 1st dislocation the investigations are done to rule out above mentioned causes of malalignment  which might lead to subsequent dislocations. Rehabilitation is started to strengthen the weak muscles & release the tight structures. Even after good rehabilitation if the dislocation recurs then one needs to undergo corrective surgery as per the enticing cause

Recurrent dislocation of the patella can have multiple factors contributing towards it in the same person so identifying it & correcting it is paramount to prevent further recurrence.