Patella Stabilisation

Lock In Stability. Move With Confidence.

Don't let a dislocating kneecap hold you back. Through targeted stabilisation, specialist knee surgeon Mr Lebur Rohman restores true patellar tracking—eliminating joint apprehension so you can move without fear.

Patella Stabilisation & MPFL Reconstruction Guide

Precision Anatomic Reconstruction, Bone-Sparing Knotless Anchors & Customized Alignment under Consultant Orthopaedic Surgeon Mr Lebur Rohman

1. Understanding Patellar Instability & Anatomy

The kneecap (patella) glides within a V-shaped groove at the end of the thigh bone (trochlea). The Medial Patellofemoral Ligament (MPFL) acts as the primary check-rein, providing up to 60% of the soft-tissue resistance preventing the kneecap from dislocating laterally. When acute traumatic dislocation occurs, the MPFL is torn in over 90% of cases, leading to recurrent instability, apprehension, and progressive cartilage degradation.

Classic Instability Symptoms

Lateral Patellar Dislocation: Visible shifting or popping of the kneecap toward the outer side of the leg.
Patellar Apprehension: Severe anxiety or fear when pushing the kneecap outward or pivoting on a flexed knee.
Recurrent Giving-Way: Buckling during athletic cutting, stairs, or quick direction changes.
Anterior Knee Pain & Effusion: Persistent swelling and deep discomfort behind or around the kneecap.

Predisposing Anatomical Factors

Trochlear Dysplasia: A shallow or flat femoral groove preventing normal patellar tracking.
Patella Alta: An abnormally high-riding kneecap that engages late in flexion.
Increased TT-TG Distance: Lateral displacement of the tibial tubercle pulling the patella outward.
Generalized Ligament Laxity: Hypermobility stretching soft-tissue restraints.

2. Surgical Solutions: MPFL Reconstruction & Joint Realignment

Mr Lebur Rohman utilizes minimally invasive anatomic techniques—including modern Arthrex® SwiveLock® and knotless FiberTak® anchor constructs—to rebuild the MPFL with exact isometric restoration.

All-Onlay MPFL Reconstruction (FiberTak® Anchors)

Biomechanical demonstration showing double knotless FiberTak® anchors creating a continuous broad onlay construct for enhanced isometry.

MPFL Reconstruction (SwiveLock® Anchors)

Anatomic MPFL reconstruction utilizing BioComposite SwiveLock® anchors on the medial patella and interference screw fixation at Schöttle's point.

3. Comprehensive Surgical Options Matrix

Every knee is anatomically distinct. Treatment is customized according to the exact mechanical cause of your patellar instability:

Procedure	Primary Indication	Surgical Technique	Clinical Goal & Benefit
Anatomic MPFL Reconstruction	Torn MPFL following primary or recurrent lateral patellar dislocation.	Graft (autograft/allograft) fixed to medial patella and femoral Schöttle's point using knotless anchors.	Restores native soft-tissue check-rein, stopping lateral tracking without over-constraining the joint.
Tibial Tubercle Osteotomy (TTO)	Increased TT-TG distance (>20mm) or severe Patella Alta.	Surgical realignment of the tibial bony insertion (medialization/anteromedialization) fixed with two compression screws.	Re-aligns the quadriceps pull vector and offloads damaged patellofemoral cartilage.
Bereiter Trochleoplasty	Severe Trochlear Dysplasia (flat or convex femoral groove).	Reshaping the trochlear bed to deepen the central groove and recreate a natural bony track.	Provides structural mechanical containment for the kneecap in flexion.
Lateral Retinacular Release / Lengthening	Tight lateral retinaculum pulling the patella laterally.	Controlled release or Z-lengthening of the outer fibrous band.	Balances lateral soft-tissue tension to complement medial reconstruction.

Why Choose Mr Lebur Rohman for Patellar Stabilisation?

Comprehensive Realignment Assessment: Detailed CT/MRI analysis evaluating TT-TG distance, patellar height (Caton-Deschamps index), and trochlear geometry before choosing the procedure.
Precision Isometry at Schöttle's Point: Fluoroscopic intra-operative verification ensuring the graft remains taut across the full arc of knee motion without over-tightening.
Bone-Sparing Knotless Anchor Tech: Ultra-small FiberTak® anchors minimizing patellar fracture risk while maximizing mechanical pull-out strength.
Dedicated Sports Return Protocol: Tailored quad-reactivation programs designed for rapid, confident return to high-demand athletic performance.

Overcome Recurrent Patellar Dislocation

Schedule a private assessment with knee specialist Mr Lebur Rohman to evaluate your patellofemoral tracking and restore joint stability.

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5. Phased Rehabilitation & Recovery Guidelines

Recovery following MPFL reconstruction focuses on protected graft healing, early quadriceps re-activation, and progressive return of knee flexion:

Phase 1: Protection & Quad Activation (Weeks 0–6)

Hinged Knee Brace: Locked in extension for walking; unlocked 0°–90° for seated range-of-motion.
Weight-Bearing: As tolerated with crutches; heel-strike gait pattern.
Primary Drills: Static quad setting, ankle pumps, straight leg raises (with brace locked), and patellar glides.

Phase 2: Gait Normalization & Mobility (Weeks 6–12)

Brace Weaning: Progressive weaning from the brace under physiotherapist guidance.
Mobility Target: Achieving full knee flexion and fluid walking gait without a limp.
Primary Drills: Stationary cycling (high seat position), step-ups, closed-chain leg press, and balance board stability.

Phase 3: Dynamic Power & Running (Months 3–6)

Strength Target: Quadriceps strength >80% compared to uninjured side.
Exercise Progression: Straight-line treadmill jog, eccentric squats, agility ladder, and low-impact plyometrics.

Phase 4: Cutting, Agility & Sport Return (Months 6–9+)

Agility Drills: High-velocity cutting, change-of-direction, and sport-specific skill integration.
Clearance Criteria: Objective passing of functional hop-testing and psychological return-to-play readiness battery.

📍 Gateshead Health NHS Knee Guidelines: Access Gateshead Health NHS Knee Joint & Injury Resources

📍 NHS TIMS Knee Portal: Access NHS TIMS Guided Rehabilitation & Exercises

6. Frequently Asked Questions Regarding Patellar Stabilisation

Why does the kneecap dislocate laterally, and why doesn't it heal naturally? +

The kneecap almost always dislocates toward the outer (lateral) side of the knee. During dislocation, the Medial Patellofemoral Ligament (MPFL) on the inner side is severely stretched or torn away from bone. Without surgical reconstruction, the torn ligament often heals stretched out, leaving the kneecap permanently unstable and prone to recurrent dislocations.

What is Schöttle's Point and why is intra-operative X-ray (fluoroscopy) used? +

Schöttle's Point is the exact anatomical origin of the MPFL on the inner thigh bone (femur). During surgery, Mr Lebur Rohman uses intra-operative X-ray (fluoroscopy) to verify this point. Securing the graft precisely at Schöttle's Point ensures the reconstructed ligament remains perfectly isometric—maintaining uniform tension whether your knee is straight or bent.

Will I need a Tibial Tubercle Osteotomy (TTO) in addition to MPFL reconstruction? +

A Tibial Tubercle Osteotomy (TTO) is only required if pre-operative CT or MRI scans reveal a significant alignment abnormality, such as a high TT-TG distance (>20mm) or an extremely high kneecap (Patella Alta). Re-aligning the bone reduces lateral pull vectors and offloads joint cartilage, protecting your MPFL reconstruction from early failure.

What is the recovery timeline for driving and returning to work? +

Desk Work: 2 to 3 weeks post-surgery.
Light Active Duties: 6 to 8 weeks once walking without a brace or limp.
Driving: 4 to 6 weeks (right leg) or 2 to 3 weeks (left leg, automatic vehicle), provided you are off strong pain medications and can perform a safe emergency brake stop.

Reclaim Unshakeable Knee Stability

Get a specialist assessment with Consultant Orthopaedic Surgeon Mr Lebur Rohman to resolve kneecap instability and return to sport with confidence.

Book Private Assessment →