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Patellar Stabilisation Surgery

by Medial Tibial Tubercule transfer

This operation involves lifting up a tongue of bone from the front of the tibia (shin bone) upon which the patellar tendon (running up to the knee cap) is attached. The tongue of bone is then swung inward (medially) and fixed down solidly with one or two heavy bone screws. The effect of this is to shift the line of muscle pull on the knee cap inward, resisting the tendency for the knee cap to dislocate outward.

Recovery from this procedure is usually quite rapid. Over the first 3-4 days there is a moderate degree of discomfort to be expected, and this is usually manageable with anti-inflammatory tablets,ice packs and regular paracetamol medication. A removable knee splint is not normally required, but if post operative pain is a problem, a splint maybe applied before leaving hospital.

Prior to discharge from hospital, it is important that you are able to get out of bed independently, and walk partial weight bearing using crutches. It is not usually necessary that an overnight stay following operation is needed, but if pain management is a problem, an overnight stay is an option. Following operation, blood loss is usually minimal. Bruising about the leg is sometimes seen, and will resolve with time.

Following operation, it is important that you regain a full range of movement in your knee as soon as possible. If you have a splint on, this should be taken off at regular intervals, and then f1ex the knee up and straighten it out regularly. It is also important to be working on tightening up your quadricep muscle group (on the front of the thigh) and doing straight leg-lifts regularly to keep muscles active. It is recommended that you return to see your physiotherapist within 4-5 days following operation, to make sure that you are regaining your range of movement and muscle strength.

Usually, crutches can be discarded within 7-10 days of operation, but keep using them until your muscle strength returns to normal and you feel confident walking without them. I will see you for your first post operative visit at 10 days. At three weeks following operation, I will see you for your second post operative visit, at which time you should have regained full movement in the knee, and your quadriceps muscle strength should be fairly good.

If you work hard on your exercises, you should make a full recovery from this operation within 6-8 weeks. The chances of having a further dislocation following this operation are low, but should any further problems with the knee arise beyond six weeks (final post operative visit) I would wish you to contact me.