A dislocating or subluxing kneecap (patella) can be an extremely debilitating condition, particularly in the young active population. It can see children, adolescents and adults limit their activity because of fear of recurrent dislocations. Some people may even find that walking is difficult and their kneecaps pop out when rolling over in bed!
When a kneecap dislocates, the ligament holding it in position is torn. If a person has other anatomical features such as knock knees, twisted bone structure, a shallow groove on the femur where the patella sits (trochlea) or very loose ligaments, then it is possible that physiotherapy will not be enough to keep the patella in position when undertaking activity. In young patients, the redislocation rate has been reported as being as high as 70%.
For this reason, it is important to undergo a thorough assessment of all the factors that may predispose your kneecap to dislocate. XR and MRI scans are required to understand your anatomy and to generate a surgical procedure that is tailored to you.
In children, certain procedures such as guided growth may be necessary to improve alignment of the legs to reduce the risk of recurrent dislocations in the future. It is critical not to miss the opportunity to perform this as once the growth plates have closed, corrective surgery is much more complex and risky.