The patella commonly also known as the knee cap which is located in front of the knee can get dislocated/slip out of position from position due to tear of the MPFL (medio patella-femoral ligament) which is a ligament in the inner side of the knee cap. At this time, a small bone chunk (osteochondral fragment) may get broken off and may lie loose in the knee which needs removal by arthroscopy. In some individuals, the patella may dislocate repeatedly due to unhealed MPFL ligament.
This is more common in females. There is usually a background history of dancing/sports, when the young girl hears a POP sound accompanied by excruciating pain and a feel of giving away of the knee.
In few cases, the MPFL maybe opened up and the fibres maybe double breasted also. However in recurrent cases, it is better to reconstruct instead of repair.
Unfortunately not always do the MPFL tears heal with rest, bracing and medications. Then they need reconstruction.
Arthroscopy aids in diagnosis, loose body removal and also assists in ensuring that the patella is in central position while tightening the reconstructed MPFL and avoids overtightening/laxity of the new ligament.
No, not all arthroscopy surgeons can comfortably perform MPFL reconstruction, just as they do ACL reconstruction/ meniscal tears. This is technically a difficult procedure.
1-3 days(patients prefer weekend surgery)
No. Besides white-collar job professionals return to work the same week
Two small stitches are only needed. Hence scars are small and cosmetically appealing. In males, the presence of hair, obscures the scar completely. For hamstrings graft harvesting, another separate incision of around an inch size is needed.
The patient can go back to work in 3-10 days itself once they are comfortable (deskjobs and IT professionals). In case of meniscal repairs, the patient can go back to work with some restrictions in day-to-day activities.
Patients usually start driving cars at around 6-8 weeks based on their comfort and also recovery.
Spinal anaesthesia or short general anaesthesia is sufficient usually.
Definetely yes. Surgery is only half the battle. Adequate exercising with preplanned protocols under the guidance of your surgeon and physiotherapist is mandatory and ensures good successful results. A brace maybe needed for some time to protect the reconstructed ligament.
I meniscal repair has been performed, you may need crutches for some time.
The patient can usually return to sports in 12 weeks