Kneecap (Patellar) Dislocation: When Is Surgery Needed?

Once a kneecap has dislocated, the ligament that holds it in place may be stretched or torn, and it can slip out again. Each episode can take a little cartilage with it. Surgery is not the first answer for everyone, but repeated dislocations are not something to keep living with. Here is how to think about when it makes sense.

Why a kneecap keeps dislocating

The kneecap (patella) runs in a shallow groove at the end of the thigh bone. A ligament on its inner side, the medial patellofemoral ligament or MPFL, holds it on line. Once that ligament has been stretched or torn, the kneecap can slip out again more easily.

Some people are built for it: a shallow groove, loose ligaments, or an alignment that pulls the kneecap outward. Others get there through one bad injury, such as a fall, a tackle or an impact. Young athletes are a common group, because the demands of their sport can outpace their anatomy.

When surgery is recommended

Surgery is generally considered when:

• the kneecap has dislocated more than once and now comes out easily
• the knee stays unstable despite rehabilitation
• there is real ligament or cartilage damage from the dislocations
• the way the knee is built makes another dislocation close to inevitable

What the surgery involves

Stabilization usually means reconstructing the MPFL, sometimes alongside realignment work. Any cartilage already damaged is addressed at the same time. The right combination comes from the imaging, how the kneecap actually tracks, and how the leg is aligned. It is not one standard operation applied to everyone.

Recovery

Rehabilitation starts straight away and is built around quadriceps strength and retraining how the kneecap moves. Physical therapy is not optional: the operation makes the result possible, and the rehab produces it.

• Ordinary activity: usually back within six to twelve weeks.
• Sport and high-impact work: commonly four to six months, depending on healing and progress.

The return to sport is decided by strength and control, not by the calendar.

The goal

The aim is a kneecap that stays where it belongs, tracks properly in its groove, and stops costing cartilage with every episode. Stabilization substantially lowers the odds of another dislocation.

If your kneecap has come out more than once, ELITE Sports Medicine can assess it at the Port St. Lucie or Palm Beach Gardens office. Read more about patellar dislocation surgery, call 561-202-8886 or request an appointment.