When is this procedure indicated?
In case of recurrent dislocations of the patella.
How is it performed?
The surgical technique involves initially an arthroscopy of the knee, through 2 small portals, from which you can view the patellar sliding, evaluate and resolve collateral problems of the knee, such as the presence of mobile bodies intrarticular, damaged menisci and better evaluate the cartilage of the patella and femoral trochlea. The reconstruction of the medial patello-femoral ligament, frequently damaged in patella dislocations, is then carried out, according to calculations estimated by the pre-opratory planning, using a tendon (gracilis), taken through a small incision in the goose foot area, or with a tendon coming from a bone bank, and fixed to the patella and femur through special devices (resorbable screws). If preoperative calculations show the need, an osteotomy of the anterior tibial apophysis is also performed, which is medialized and/or lowered and fixed with one or two metal screws, thus allowing optimal patellar sliding. In this case, the incision is single and elongated from the patella to the anterior tibial apophysis.
Rehabilitation program changes depending on surgical technique and other patient-related variables. After surgery, it is important to perform daily exercises for the gradual recovery of the mobility of the knee, walking is allowed with progressive load and the aid of 2 crutches, the limb should be kept elevated to avoid excessive swelling. Essential for the stability of the patellofemoral and of the whole lower limb are the exercises for the maintenance and reinforcement and proprioceptive re-education of the quadriceps muscle that should be performed continuously for many months after surgery.
- Instability recurrence