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The most likely time for the patella to shift laterally is during the first 20–30 degrees of flexion as the quadriceps tighten simultaneously and pull the patella laterally. Beyond 30 degrees, the quadriceps tendon and patellar ligament pull the patella posterior into the groove of the knee joint making lateral dislocation of the patella ...
The surgery involves exposure of the front of the knee, with detachment of part of the quadriceps muscle (vastus medialis) from the patella. The patella is displaced to one side of the joint, allowing exposure of the distal end of the femur and the proximal end of the tibia .
The surgery is quick (typically lasting between 30 and 90 minutes), minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement). Chronic articular cartilage defects do not heal spontaneously. [1]
Knees following ACL reconstruction surgery. A patellar tendon graft was used. Discoloration of the left leg is from swelling that drained from the knee to the shin. The patellar tendon connects the patella (kneecap) to the tibia (shin). The graft is normally taken from the injured knee, but in some circumstances, such as a second operation, the ...
The patellar ligament is often used, since bone plugs on each end of the graft are extracted, which helps integrate the graft into the bone tunnels during reconstruction. [11] The surgery is arthroscopic, meaning that a tiny camera is inserted through a small surgical cut. [9]
Surgery after a first dislocation is generally of unclear benefit. [6] [4] Surgery may be indicated in those cases where a fracture occurs within the joint or where the patella has repeatedly dislocated. [3] [4] [5] Patellar dislocations occur in about 6 per 100,000 people per year. [4] They make up about 2% of knee injuries. [1]
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