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Preserving Joint Function: Patella Realignment Surgery for Subluxation
Some of the most common orthopedic injuries affecting men and women equally involve the knee joint. The load-bearing joint is subjected to more on a day-to-day basis than any other joint in the body.
Though, advances in orthopedics have added longevity to this essential joint. Today, there are a variety of treatment options available to preserve joint function. One such procedure is known as Patella Realignment Surgery for Subluxation.
The patella is the thick, flat triangular bone located at the front of the knee joint, also known as the kneecap. The patella is one of thee bones, along with the tibia and femur that make up the knee joint. It is located inside of a tendon that connects the quadriceps muscle of the thigh to the tibia just below the knee joint. It is the second largest sesamoid bone (a bone embedded within a tendon) in the human body.
The normal motion of the kneecap is to slide up and down a groove known as the trochlea. When the patella slides out of the normal position in the center of the thighbone, it is referred to as patella subluxation. The improper tracking, or irregular sliding movement, will cause pain in front or around the sides of the kneecap – and in extreme cases can lead to dislocation of the patella. This irregular sliding motion can be a result of a blow to the area, or poor knee biomechanics and alignment.
In less severe cases, the best treatment for patella subluxation is through conservative therapy, a non-surgical approach. Conservative therapy may include a variety of techniques such as the use of a Cryo/Cuff®. The Cryo/Cuff® is a cold therapy device which is placed over the dressings that compress and cools the inflamed area. It is also always recommended for patients to lose unnecessary weight and to establish a regular exercise program. Strengthening exercises of the hip abductor and hip flexors help ensure better control of the kneecap. The Step Box may also be used as an inexpensive device to perform closed chain knee extension exercises, improving range of motion.
When a severe injury is nonresponsive to the conservative therapy, Patella Realignment surgery is recommended. This surgery is recommended for patients experiencing significant pain or recurrent dislocation. Exploratory arthroscopy is first performed to confirm the problem and to correct any other intra-articular abnormalities. Arthroscopic surgery involves a tiny camera attached to a fiber optic light source that is inserted into the joint through a small incision. This camera gives an interior view the joint on a television monitor the orthopedic surgeon is watching. In arthroscopic procedures, pressurized water is used to inflate the joint area, permitting maneuverability and any necessary debris removal.
A lateral release procedure is then performed through an arthroscopic incision. An incision is made just above the knob of the knee, known as the tibial tubercle. The tibial tubercle and its attached patella tendon is separated from the tibia and moved forward and medially toward the inside, correcting the poor alignment of the kneecap in relation to the femur. Recovery from arthroscopic surgery is encouraged one day at a time, as overexertion may cause a setback. Running and swimming typically resume at four weeks and athletes can generally return to the field or track in three months.
Although among the innovators in the field of Arthroscopic Surgery, Dr. Mark Sanders of The Sanders Clinic for Orthopaedic Surgery and Sports Medicine considers surgery only as a last resort. Dr. Sanders offers the most advanced Arthroscopic procedures for patients non responsive to conservative treatment. To learn more about Dr. Sanders and The Sanders Clinic, log onto www.sandersclinic.net or call 713-622-3576, or 1-888-8 DR MARK today.
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Houston Orthopedic and Sports Medicine Physician Mark Sanders, M.D., Joins American Orthopaedic Foot and Ankle Society
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