Patella stabilization is the process of solidifying the kneecap into place so that it is not at risk of displacement. The treatment and surgery that is best for your patella stabilization is based on a number of factors, including your age, current health and health history, and your history with other medications and treatments.
Patella stabilization is vital to ensuring that the knee joint continues to function properly and leaves you mobile and pain free. If you are in any way concerned that your knee is not stable, it is important to talk to your doctor. To diagnose your condition, your doctor will start by asking a series of questions about your activity and symptoms, as well as perform a physical exam. To determine the appropriate treatment, the following techniques will be used:
- X-ray (radiograph) – This is usually the first test performed to diagnose any injury that has occurred to the bone itself, as well as to find out the placement of the bone. It is done using electromagnetic radiation, which is sent through the knee area. The bone then absorbs the radiation, which is reflected in a black-and-white image.
- Computed tomography scan (CT or CAT scan) – A CAT scan is an imaging test that combines computer technology with X-ray technology to create a three-dimensional image that can help determine the alignment of the bone. This, in turn, helps point out the appropriate treatment methods.
- Magnetic resonance imaging (MRI) – This test is also used frequently to get a better image of the injuries within the knee and the surrounding ligaments that are used to stabilize the patella, or kneecap. You will be placed in a vessel that will generate magnetic radio waves. The resonance from the vibrations caused by these waves will produce an image that will give more detail. Unlike a CAT scan or X-ray, this technology does not use radiation.
In many cases, patella stabilization is done using a brace. This is usually combined with significantly lowered activity levels and anti-inflammation pain medication to reduce swelling and symptoms. Many people, especially athletes, continue to train in the pool and do physical therapy with a trained professional to increase mobility, while the joint remains immobile.
In some cases, the risk to the knee may be more serious and require surgical treatment. The aim of any patella stabilization procedure is to properly attach the ligaments to the kneecap and keep them from moving around during activity. Most patella stabilization procedures are done using one of the following techniques:
- Reconstruction with graft – In some cases, the patella may continue to shift and move around, which eventually can lead to other problems. To stabilize the bone, a graft (a piece of living tissue) is used to strengthen the damaged ligaments in the knee. This is done using a graft either from the patient or from a cadaver. Once the graft has been added, screws typically are used to hold everything in place until it is healed.
- Realignment of the patella – This procedure is done when the groove where the patella sits inside the tibia is too shallow, causing the kneecap to sit higher up. Through surgical intervention, the groove is deepened and the patella is realigned to allow it to sit properly in the socket part of this ball-and-socket joint.
- Arthroscopic procedure – This surgery is done to remove damaged pieces of the bone that cause the patella to become unstable. To do this, the cartilage is shaved down or removed completely from the kneecap to make it align better within the socket and work as it should.
- Lateral release – This is another arthroscopic procedure, which means that it involves only a small incision of approximately two inches. It is done by releasing the ligaments around the knee, allowing the knee to sit in the socket better and making it more stable all around. This is a unique procedure and should be performed only in certain situations, as determined by an orthopaedist.
The multidisciplinary team of knee experts at Northwell Health Orthopaedic Institute performs patella stabilization surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.
A significant portion of the research surrounding patella stabilization procedures has to do with the proper treatment of various conditions. The most common condition that requires one of these procedures typically involves the kneecap slipping from its socket, or groove, in the thighbones of younger people during sporting activities.
One of the most disputed issues surrounding treatment is whether surgery is required or if the patella can be treated using braces and physical therapy instead. While it is a good idea to avoid surgery if at all possible, surgical intervention can lead to fewer dislocations in the long-term, which can have more benefits than attempting to brace the injury.
In a study done by Cochrane Summaries, a health research institute, researchers followed a series of primary dislocation cases. In most of the cases, there was no difference in recovery and all patients seemed to have similar results over the following years. However, in one of the study groups, complications were found in the surgical test group. While this has not verified that nonsurgical approaches are best, it does give more insight into what doctors should attempt in primary cases.
As research on treatment is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.