Patellofemoral (Kneecap) Instability and Pain - Patient Education and Solutions

[@lorinajera2863]

Thankful for Doctors like you.

[@paulettegangemi2935]

Doc saved my knee with an MPFL. When other surgeons told me I’d never ski again, never exercise again. 8 years post-op I’m a ski patroller and skiing at a higher level than I did on the race team in college. Thank you Doctor Strickland!

[@gunnargerritsen9154]

On 2-12 I will have anteromediale tuberositas tibiae transposition. And on 6 oktober my left knee will be done. My shoulder orthopedic surgeon had her studie in Boston.

[@kill3r672]

Hi Doc. thank you for the videos - I have been told (following MRIs) I have severe patella alta (insall salvati ratio 1.8) with some lateral tilt, Q angle is increased bilaterally, lateral subluxation of the patella three fourths laterally & medially, dysplastic trochlea, TT-TG distance of 26mm, severe chondral damage to the patella & to the dysplastic trochlea, Clarke's test is positive, tibial tuberosity placed laterally.... I have been advised to not take part in any physical activity that puts force through the knee & have been referred to be seen by a specialist surgeon, but the wait time is long as I am going through the NHS (UK) - I know it is hard to say without images, but I'm guessing this will result in surgery- so my question is, what sort of surgery would typically be performed to fix the above?

[@SabrinaStricklandMD]

In the United States we have different option for cartilage repair than the UK. It sounds like you would need a tibial tubercle osteotomy with a cartilage transplant for your patella and trochlea. You should be able to be active once this is fixed. Best of luck finding treatment.

[@kill3r672]

Thank you @@SabrinaStricklandMD for the response and the kind words. Keep doing the good work you do and stay safe.

[@matthewlindsay1372]

I'm 39 and just had a knee scope to remove several large bodies from my knee (a half dozen of 1cm diameter). This is my third surgery, second scope (originally surgery at 16 yrs old). Doc after my recent surgery/scope said it was worse than he thought and I have Stage 3 and 4 wear of my cartilage on the underside of my knee cap and on the groove where my knee cap rests. I don't have instability, but they believe it is not resting correctly. They said a possible option is a "Tibial tubercle osteotomy" to get better knee cap alignment with the groove. I'm told I'm not a candidate for cartilage transplant given I have a 'kissing' wear problem. Anyway, my question is this "Tibial tubercle osteotomy" the logical next fix? If so, should I do it sooner than later so I don't wear away what cartilage I have left?

[@SabrinaStricklandMD]

Hi Matthew. This is a complicated question to answer without actually seeing your MRI. Bipolar or kissing lesions can be treated with an cartilage transplant on both the patella as well as the front of the femur. This is virtually always done with a tibial tubercle osteotomy unless your alignment is optimal. At 39, we certainly try to do everything possible to avoid a partial knee replacement. I don't know if you live anywhere near New York, but I'd be happy to see you. I also do telehealth for presurgical visits or you could see a patella specialist if there is one in your area.

[@SabrinaStricklandMD]

Here's contact information for my office if that works for you: sabrinastrickland.com/contact-dr-sabrina-strickland/