The patellar realignment procedure is a specialized orthopaedic procedure that corrects misalignment in the kneecap. When non-surgical treatment fails to relieve chronic pain, instability or dislocation of kneecap, it becomes necessary. We’ll also identify symptoms that signal the need for an intervention and determine when causes for patellar realignment surgery is the best option.

What is Patellar Realignment Surgery (PRT)?

The patellar realignment procedure is used to restore the proper alignment of the knee joint and correct the position the kneecap. Pain, instability and repeated dislocations can occur when the patella doesn’t track correctly in the femoral (trochlear) groove. According to the severity of misalignment, the procedure may include soft tissue repair, reshaping the bone, or realigning the tendon.

Patellar Realignment Surgery: What are the main causes for patellar realignment surgery?

Understanding the causes for patellar realignment surgery can help in the early diagnosis and management of this condition. The following are the main underlying factors.

1. Recurrent patellar dislocations

Repeated kneecap dislocation is one of the main causes. The patella slides out of its normal position, which is usually to the outside of your knee. Chronic instability can result from repeated episodes of ligaments or cartilage being stretched and damaged. The joint may need to be realigned and stabilized by surgery.

2. Congenital or Developmental Abnormalities

Anatomical abnormalities can affect the alignment of the kneecap. A shallow trochlear grove or a kneecap that rides high (patella alta), for example, can increase the risk of dislocation. In these cases, realignment of the patellar cartilage is often recommended in adolescence and adulthood to avoid long-term damage.

3. Injury or Trauma to the Knee

Direct trauma, such as falls or sports injuries, can cause the MPFL to tear or dislocate. After an injury, the structures holding the kneecap in position may not heal properly, requiring surgery to restore knee function.

4. Ligament Weakness or Laxity

Patellar subluxation and dislocation are more common in people with generalized ligament laxity. This is often caused by connective tissue disorders such as Ehlers Danlos syndrome. realignment surgeries can be used to stabilize the kneecap and provide structural support when conservative treatment fails.

5. Misalignment of Lower Limb

Sometimes the cause is a larger issue, such as knock-knees (genu vagum) or femoral anterior anteversion. These structural misalignments may place additional lateral forces on the patella and cause it to move out of alignment. In such cases, surgical correction of the tracking path of the patella may be necessary.

6. Quadriceps Muscle Imbalance

A weakness in the vastus medialis (VMO) can lead to an incorrect tracking of the patella. If physical therapy fails to improve muscle coordination and knee alignment, surgery may be required.

7. Previous Knee Surgery

In some cases, patients will require patellar alignment surgery if previous procedures such as arthroscopy or partial patella surgery have failed. Revision surgery is often performed to correct alignment or relieve persistent pain.

The signs and symptoms of a need for surgery

It is important to identify symptoms that could indicate a need for surgery.

Kneecap dislocations that are chronic or recurrent
A persistent anterior knee pain
The sensation of the knee giving in or buckling
Limitation of knee range of motion
Deformity or misalignment that is noticeable
Difficulty performing daily activities such as walking, climbing stairs or squatting

Surgery may be recommended if these symptoms affect quality of life and conservative treatments like physiotherapy and bracing do not help.

Different types of Patellar Realignment Techniques

The surgical technique depends on the cause of misalignment as well as the severity of the condition. Common techniques include:

Medial Patellofemoral Ligament (MPFL) Reconstruction
Lateral Release Surgery
Tibial Tubercle Osteotomy (TTO)
Trochleoplasty
Quadricepsplasty and muscle rebalancing procedures

These procedures are designed to restore the proper motion pattern of the kneecap during knee extension and flexion.

Who is the Ideal Candidate for a Surgery?

If you are:

Do you have a history or frequent dislocations of the kneecap?
Maltracking can cause knee pain that persists
Diagnosed with a structural anomaly causing instabilities
You have not improved with non-surgical treatment
You want to resume an active or athletic life with a stable and pain-free knee

Benefits of Patellar Realignment Surgery

When performed correctly, the procedure has many benefits.

Restores stability to the knee joint
Pain relief and improved mobility
Stop further cartilage damage and arthritis
Enhances quality of life and function
Confidence to return to sport and daily activities

Conclusion

Understanding the causes for patellar realignment surgery will help patients, caregivers and healthcare providers to take action. Correcting misalignment, whether due to congenital defects or trauma, is essential for maintaining knee health and preventing complications in the long term. Consult an orthopedic specialist if you are experiencing chronic knee pain or instability.