Patella problems are not uncommon. Normal patellofemoral anatomy provides perfect stability. Patella instability is complex with various aetiologies and anatomical factors contribute to the symptoms. Patellar motion is affected by a complex interaction between muscles, ligaments, bone morphology and lower extremity alignment.
First time patella dislocation commonly occurs in the young, physically active population. The primary stabiliser, the medial patellofemoral ligament is frequently torn.
Acute patella dislocations can result in patella instability, pain, recurrent dislocation, patellofemoral arthritis and decreased level of sporting activities. Recurrence rates of dislocations can be as high as 40% to 48%.
We treat all our first time patella dislocations conservatively in a patella stabilising brace and rehabilitation.
The aim of conservative treatment should be immobilisation and physical rehabilitation.
Surgical procedures can be successful in preventing recurrent instabilities, but it does not reduce the incidence of patellofemoral arthritis.
Surgery is considered at recurrent dislocations, large osteochondral fragments, bony avulsions, patients not improving with adequate rehabilitation.