KNEE SURGERY GLASGOW
Patellar Stabilisation
What is a patellar stabilisation procedure?
Patellar stabilisation surgery is an operation to prevent the kneecap (patella) from repeatedly slipping out of place (dislocating) or feeling unstable. There are different surgical methods, and the choice depends on your knee anatomy, the severity of the problem, and your activity goals.
Why might I need a patellar stabilisation?
You may be advised to have surgery if you have:
Recurrent kneecap dislocations despite physiotherapy
Persistent pain, swelling, or loss of function due to patellar instability
Structural problems in your knee that increase the risk of dislocation (such as shallow groove, malalignment, or abnormal tracking of the kneecap)
Difficulty returning to sport or normal daily activities because the knee “gives way”
What does this type of surgery involve?
The most common operations are:
MPFL (Medial Patellofemoral Ligament) Reconstruction
The MPFL is the main soft tissue stabiliser that holds the patella in place.
In this procedure, a graft (usually taken from one of your hamstring tendons) is used to reconstruct the ligament.
The graft is fixed between the inside of the kneecap and the femur, restoring stability.
Tibial Tubercle Osteotomy (TTO)
The bony bump on the shinbone (tibial tubercle), where the patellar tendon attaches, is cut and repositioned.
This realigns the pull of the kneecap, reducing the tendency to dislocate.
The bone is fixed with screws, which may need removal later.
Trochleoplasty (less common)
If the groove at the end of the femur (trochlea) is abnormally shallow, it can be reshaped surgically.
This creates a deeper groove for the patella to sit in, improving stability.
Usually reserved for patients with significant anatomical abnormalities.
These operations are often performed arthroscopically (keyhole) combined with small incisions for graft or bone work.
What will the recovery be like after surgery?
Hospital stay: this can be done as a day case or a single night stay.
Weight-bearing: often partial with crutches initially, progressing to full weight over a few weeks.
Bracing: sometimes used after MPFL reconstruction or TTO.
Physiotherapy: essential to restore movement, strengthen muscles, and retrain stability.
Return to sport: typically 6–9 months, depending on the procedure and progress.
Trochleoplasty and tibial tubercle osteotomy generally have longer recovery times compared to MPFL reconstruction.
What are the risks of surgery?
General risks:
Pain
Swelling
Stiffness
Infection
Blood clots
Specific risks:
Graft failure or recurrence of instability (after MPFL reconstruction)
Pain or non-healing at the bone site (after TTO or trochleoplasty)
Screw-related irritation requiring later removal
Rarely, cartilage damage or ongoing pain despite surgery
Are there alternatives to surgery?
Physiotherapy: strengthening of the thigh, hip, and core muscles is the first-line treatment for most patients.
Bracing or taping: can provide additional support for sport and activity.
Activity modification: avoiding high-risk twisting or pivoting activities.
If instability persists despite these measures, surgery may provide the best long-term solution.
