Question 1

Why does my kneecap keep dislocating?

Accepted Answer

Recurrent dislocations can be related to underlying anatomy, such as a shallow trochlear groove or ligamentous laxity. They can also result from damage to the structures that restrain the patella during the initial dislocation.

Question 2

Does a first-time patellar dislocation require surgery?

Accepted Answer

Usually not. Most first-time dislocations are treated without surgery unless there is significant articular cartilage damage, an unstable cartilage fragment, or a symptomatic loose body.

Question 3

What damage can occur when the patella dislocates?

Accepted Answer

As the patella dislocates, it can scuff the end of the femur on its way out, damaging the articular cartilage. This can create cartilage fragments or loose bodies and may contribute to arthritis over time.

Question 4

What is the MPFL?

Accepted Answer

The medial patellofemoral ligament, or MPFL, is one of the primary structures that restrains the patella from dislocating toward the lateral side of the knee. It acts like a leash, limiting lateral movement of the patella, and is commonly injured during dislocations.

Question 5

Can patellar instability lead to arthritis?

Accepted Answer

Yes. Repeated dislocations can progressively damage the articular cartilage of the patella and femur, eventually leading to patellofemoral arthritis. This is one reason we consider surgical stabilization for recurrent instability. When surgery is indicated, treatment is best performed before significant arthritis develops.

Question 6

When is MPFL reconstruction recommended?

Accepted Answer

MPFL reconstruction is generally recommended for recurrent patellar instability or additional dislocations despite appropriate rehabilitation.

Patellar Instability