Surgical procedures to correct patellar alignment

Realignment surgery is surgery to correct or improve abnormal patellar tracking, and improve kneecap stability.

Realignment procedures include -

• proximal realignment procedures
• distal realignment procedures
• constructive procedures
• destructive procedures

You need to be aware, though, that competent physiotherapy is usually the first line of management, and that surgery should be considered only when this fails.

 

Proximal realignment procedures

By 'proximal realignment' we mean that the extensor mechanism problem is adjusted by an operation involving structures above or at the level of the patella -

• lateral release
• medial reefing
• medial plication
• Galleazzi procedure (hamstrings tenodesis)

 

Distal realignment procedures

By 'distal realignment' we mean that the extensor mechanism problem is adjusted by an operation involving structures below the patella -

• Hauser procedure
• Roux-Goldthwait procedure
• Maquet procedure
• Fulkerson osteotomy
• Elmslie-Trillat procedure
• many variants and modifications (mostly involving 'tibial tuberosity transfer')

 

Constructive procedures

• trochleoplasty

 

Destructive procedures

• patellectomy