The patella is an intrinsically unstable joint due to its shallow bony geometry. It is stabilised by the muscles and ligaments surrounding it.
Patella dislocation is a common injury which tends to occur in twisting sports. It can occur by contact and non contact mechanisms and is common in sports such as basketball, netball, football and rugby. When the patella dislocates you usually feel 2 ‘pops’, one when it ‘pops’ out and the other when it ‘pops’ back in. The knee usually swells immediately and is associated with pain around the front and side of the knee. Usually you are unable to continue with the game. Unfortunately ACL tears are not uncommonly mis-diagnosed as patella dislocations, which can lead on to problems in the future.
In a young sporting and active population the risk of recurrent repeated patella dislocation approaches at least 50 to 60%. This can be prevented with early diagnosis and acute minimally invasive surgery to repair the injured ligaments. This surgery however has to be done within 2 weeks of the injury otherwise the window of opportunity is missed. TheKneeDoc offers the facilities for rapid diagnosis and treatment. The surgery is followed by an accelerated rehabilitation programme under our direct supervision.
Chronic Recurrent Patella Dislocation
If the acute dislocation is mis-diagnosed or missed the condition can become recurrent. You tend to get repeated dislocation with twisting activities and many people will have reduced their activity level prior to seeking treatment.
TheKneeDoc offers specific surgery to correct all of the multiple disorders that can cause recurrent patella instability. By addressing all of the components of the instability it should prevent further instability episodes. The surgery is tailored to the individual’s abnormalities and requires a detailed assessment both clinically and radiologically before a treatment plan can be formulated. It is followed by a rehabilitation programme which is supervised by TheKneeDoc to allow return to function.
Chondral Injuries/OsteochondritisDissecans (OCD)
Damage to the lining (articular) cartilage of the knee joint is actually quite common. It can be traumatic or something that develops insidiously, when it is called OCD. If the piece of cartilage is knocked off it can act as a loose body causing the knee to lock and jam. This would require keyhole surgery to remove the piece. The more challenging aspect of treating this condition is what to do with the area in the cartilage which has been damaged and is now absent from. There are a number of techniques which can be used. TheKneeDocutilises state of the art, cutting edge technology to undertake cartilage transplantation where appropriate. This involves a keyhole procedure to take some cartilage from your joint from where it is sent to the lab to grow more cells. At the second operation the cells are then implanted into the knee. A specific rehabilitation programme is then followed and your progress is constantly monitored by TheKneeDoc. This is the only technique that will allow normal cartilage to redevelop in the knee and it is not widely available in the United Kingdom. There are only certain surgeons and centres available to offer this, of which TheKneeDoc is one.
Chondral injuries commonly occur in conjunction with ligament injuries of the knee and kneecap dislocation.
Fibula Head Dislocation
The fibula is the smaller of the two bones in the leg. It is joined to the shin bone at the top and at the bottom. Occasionally the joint at the top can be disrupted with certain knee injuries. It is an uncommon injury but can lead to problematic pain around the upper part of the shin bone and around the knee. It is commonly mis-diagnosed. There are a number of treatment options for this condition and as a last resort, should they not work, there is a surgical option available.