Recurrent Dislocation of patella (knee cape)

This is a common problem seen in the young group of the community. It may be associated with certain hyper-laxity syndromes. but some times occur as traumatic episode on the first instance and if not treated properly will end up with recurrent episodes of dislocation of Patella. It is a very disabling condition, Patella dislocates with minor twist of knee, while dancing, turning on a kerb or playing pivoting sports like tennis or badminton, and squash etc.

It is vitally important to treat the first time dislocation properly.  Therefore all first time dislocations should be reduced  and investigated with MRI scan. Previously, we were not aware of the importance of ligament called MPFL (Medial Patello Femoral Ligament), which is ruptured in the post traumatic dislocation of patella, it was not investigated  and not repaired in the past. Most of the time was treated with plaster cast and followed by physiotherapy, these cases were more likely to become recurrent dis-locators of patella.

Thanks to new awareness and technology to identify the rupture and possible to repair in specialised hands. I  have developed a protocol in our orthopaedic department for all the patellar dislocation to be admitted and investigated with MRI scan, and if MPFL is ruptured I repair them acutely.

I have been working on this protocol for the last 5 years and  I am very pleased to see that post traumatic recurrent dislocation rate is dramatically reduced.  Now I request all the doctors who  receive any patient in A/E please admit them and investigate them with MRI scan, so if possible  I repair the MPFL and prevent recurrent dislocation.

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