The knee is a complicated joint. Not only is it fully articulated, with a wide range of motion, it's also capped a with a flat bone—the patella or kneecap—that provides additional support and stability. However, damage to the kneecap can lead to a condition in which it's subject to repeated dislocation. When this happens the best solution is surgery to stabilise the kneecap and prevent future dislocations.
The knee is a joint that looks and functions just like a hinge. The ends of the femur (thigh bone) and tibia (shin bone) come together at the knee, where they are articulated with ligaments, muscles, and cartilage. The kneecap is a flat bone that attaches to the femur, and covers the front of the knee joint. The kneecap protects the front of the joint, and also helps to make it stronger and more stable.
Dislocation of the kneecap happens when the kneecap slides out of place, causing severe pain and swelling. This can happen due to a direct impact that knocks the kneecap from its normal position, or a sharp twisting motion of the knee or ankle, where the impact of the motion forces the kneecap out of place. Some people have a high risk of suffering from repeated dislocation of the kneecap; for instance, it's a relatively common injury in sports that involve movements where the knee is rotated.
Sometimes the kneecap can be manipulated back into place without the need for further treatment. However, after each dislocation the risk of it happening again increases. People who suffer from repeated dislocations of the kneecap have a high risk of additional problems such as osteoarthritis of the affected joint.
Repeated dislocation of the kneecap makes it increasingly likely that further dislocations will occur. This is because with each successive dislocation, the tissues that hold the kneecap in place become weaker. As a result, kneecap dislocation needs to be treated with care to minimise the risk of future problems.
Conservative treatment of kneecap dislocation includes rehabilitation of the knee joint, plus physical therapy to strengthen it and reduce the risk of further dislocation and other problems such as osteoarthritis. However, if dislocation continues to be a problem then surgery may be the only solution.
Surgery to stabilise the kneecap typically focuses on an interior ligament that holds the kneecap in place over the knee joint. This ligament—called the medial patellofemoral ligament—weakens progressively with each dislocation, so strengthening it reduces the possibility of further dislocations. An alternative option is a so-called “bony” operation in which the attachment point for the kneecap tendon is moved to a new position on the tibia. This relocation provides extra stability for the kneecap and helps prevent dislocation.
After surgery, recovery and rehabilitation largely depends on the kind of surgery a patient has. Both kinds of surgery require a period of recovery in which the leg is protected from bearing any weight, and the patient may also wear a splint or brace to provide support for the kneecap. In general, the healing process is faster after ligament surgery than after surgery that involves the tibia bone.
Everyone is different when it comes to healing. Some people heal more quickly than others, so when it comes to healing after surgery, the focus is on healing at your own pace. Generally, most people can walk with the use of crutches or a similar mobility aid the day after surgery, and can try a no-impact form of exercise such as swimming or stationary bike riding after 2 to 4 weeks.
I am writing to thanks you & your staff fro the wonderful work you did on my hip repllacement. It is so nice not to be in constant pain and it's enjoy able to go for a walk now & not dread it as before. I can't thank you + the staff at the cavell hospital enough.
After years of arthritic pain, steroid injections, physiotherapy and arthroscopy (which actually made things far worse)... I now feel like a new woman thanks to the knee surgery you performed last month - I have no doubt this is due in no small part to your skill as a surgeon. The wound healed quickly, recovery has been rapid, without any complications and the scar is neat and beautifully stitched!!
Having recently undergone a full left knee replacement I am 100% satisfied with everything Mr Saksena and his team at The Cavell provided. I was given plenty of advice both before and after my surgery, which was very reassuring. My recovery has been rapid with minimal pain and within 8 weeks I had full extension and 130 degree flexion back in the knee. I wouldn't hesitate to recommend Mr Saksena as an orthopaedic surgeon.
I had a total knee replacement with Valgus Deformity 7 weeks ago, and this gave the surgeon extra work to do, I only have good things to say about this surgery and after care with all staff involved at Chase Farm Hospital, as in my experience I have heard a lot of good and bad things about this type of surgery, Well I can only say that if anyone has concerns about this please try not to worry it is worth while as it has given me a new lease of life to what I had before, and yes the first 2 weeks are the worse, but please do try your exercises, because as they say you only get the real benefit if you are prepared to do your bit. Thanks very much for my new lease of life yet again.
I was very fortunate to be referred to Mr Saksena as an NHS patient and was very impressed with the treatment and care provided by Mr Saksena and the whole team at Cavell Hospital. Once discharged, someone was always available to talk to you and an appointment was made immediately if you needed to see a nurse (which I did several times, due to a normal discharge from my wound). The entire staff were all friendly, cheerful and efficient. The scar is very neat and after 7 weeks I am walking well and just using a stick outdoors.
I would like to just sincerely thank you for the job you did on my knees, both of them. Before I had my knees replaced I was in constant pain, which had been the case for nearly 5 years. It was so bad that I often wondered what the use was in living! Now, nearly 2 years later, I feel I have my life back. I can now walk without pain and every single day, and I mean every single day, I walk the roads that I walked pre-operations and I remember the pain that I was in for every small distance I had to walk. Now, I walk with a smile on my face and a thrill in my heart, so very grateful for having the freedom to enjoy walking once again. I also have great fun going with the grandchildren to the park and playing with them, which before the operation was impossible as all I could do was basically sit and supervise them. So there too there is a huge change.
You did a total knee replacement on my right leg on 22nd March in the Kings Oak Hospital and it has been very successful. I am now almost pain free with the knee getting stronger each day. I would like to thank you and your excellent medical team for doing such a neat job. I would also like to thank the wonderful nurses at the hospital who were always cheerful and efficient.
In September 2014 I underwent a knee replacement operation. Mr Saksensa was an amiable professional with a calming influence and caring nature. His team were friendly and supportive. My knee replacement was a complete success and I am still enjoying my favourite sport of skiing.
You performed a partial meniscectomy at Highgate Hospital in late april. I would like to thank you for your hardwork; the problem has been entirely resolved and I am pretty sure that is down to the procedure rather than the passage of time as the condition persisted during the prior two months. Some part of that is surely down to your skill.