Understanding Patellofemoral Pain and Instability

The patellofemoral joint is where the kneecap glides in a groove at the end of the thigh bone When alignment or soft tissue balance is abnormal the kneecap can track poorly causing pain in the front of the knee grinding and sometimes a feeling that the knee is about to give way In some people the kneecap actually dislocates jumps out of the groove often during sports or a twisting injury leading to sudden pain swelling and difficulty weight bearing After one dislocation the risk of another increases especially when there are underlying anatomical factors such as a shallow groove high riding patella or increased distance from the tibial tubercle to the groove

Non Surgical Care

Most patients with anterior knee pain and even a first time dislocation are initially treated without surgery Physiotherapy focuses on strengthening the quadriceps especially the vastus medialis muscle stretching tight lateral structures and improving hip and core control Activity modification taping bracing and correction of foot mechanics with insoles may reduce symptoms Many individuals improve enough to avoid surgery but those with recurrent dislocations persistent giving way or clear structural risk factors are candidates for operative stabilisation

Soft Tissue Stabilisation Medial Patellofemoral Ligament Reconstruction

The medial patellofemoral ligament is a key soft tissue stabiliser that guides the kneecap into the groove during early flexion and it is commonly torn during a dislocation episode Surgical reconstruction of this ligament using a tendon graft from the patient or a donor has become the most widely performed procedure for recurrent instability Through small incisions the surgeon creates tunnels in the kneecap and the inner thigh bone at anatomically defined points and passes the graft fixing it with screws or anchors The new ligament acts like a seat belt to keep the patella centred while still allowing normal movement

Bony Realignment Procedures

When malalignment is significant for example if the tibial tubercle where the patellar tendon attaches is too far outward or if the femur is rotated bony procedures may be added to improve tracking A tibial tubercle transfer repositions this attachment more towards the centre and sometimes slightly forward or backward to change pressure distribution on the cartilage In rare cases of very shallow or misshapen trochlear groove reshaping operations called trochleoplasty may be performed in specialised centres Some patients also benefit from distal femoral osteotomy when knock knee deformity contributes to lateral instability

Rehabilitation and Outcomes

After medial ligament reconstruction with or without bony realignment patients usually use a brace and crutches for a few weeks while starting gentle range of motion exercises Physiotherapy then progresses to strengthening of quadriceps and hip muscles neuromuscular training and gradual return to squatting stair climbing and sports Most people regain stable kneecaps with marked reduction in dislocation episodes and improved confidence in the knee Long term outcomes depend on addressing all contributing factors soft tissue bone alignment and cartilage status in a comprehensive plan

Why Choose Livasa Hospitals for Patellofemoral Surgery

Livasa Hospitals provide a patellofemoral focused service where surgeons evaluate alignment ligament integrity cartilage condition and overall limb mechanics using clinical assessment and advanced imaging Surgical options include medial patellofemoral ligament reconstruction tibial tubercle transfer and corrective osteotomy where indicated combined with structured physiotherapy for long term stability Patients from across Punjab receive a personalised pathway that addresses pain instability and underlying risk factors rather than relying on a single technique

Livasa Hospitals Punjab Network Contact

Livasa Healthcare Group Network of Multi speciality Hospitals in Punjab
Corporate Office Phase 8 Industrial Area Sector 73 Punjab 160071 India