Mr Michael Moss

Consultant Orthopaedic Surgeon

01243 753032

A lot of people occasionally suffer some discomfort around their patella (kneecap) during normal activity or exercise. Often, these symptoms are troublesome but not debilitating and in many cases can be resolved by physiotherapy and muscle retraining.

However in a small group of people the patella does not sit normally on the front of the thigh bone (malalignment) and does not move normally across the front of the joint (maltracking). This can cause high pressure areas and can accelerate wear because of the “bad fit” of the patella on the femur. Most commonly, this is due to the patella situated far too laterally (on the outside aspect of) the femur.

Realignment of the patella aims to address this maltracking problem and restore the patella back into the normal position on the centre part of the femur. By performing this procedure, I hope to lessen the immediate discomfort of the under surface of the patella and reduce some of the long-term changes that may occur due to patella malpositioning for the patient.

Patients who have lateral maltracking will be diagnosed by a mixture of clinical examination, x-rays and dynamic MR scanning. Dynamic MR scanning allows an active picture to be built up regarding the movement of the patella during knee function. It also provides an indication and picture of the cartilage on the under surface of the patella and any subsequent damage that may have been sustained.

There are several procedures I am able to carry out to correct this depending on the severity and wear of the patellofemoral joint. As your consultant, I will advise you accordingly. The different procedures range from relatively simple arthroscopic (keyhole) procedures through ligament and tendon rebalancing to the more complex bone moving (osteotomy) operations.

Frequently Asked Questions

Why do so many people need their joints replaced?

The most common reason is osteoarthritis which causes a patient to experience aching, stiffness, and eventual loss of mobility within the knee joint. Inflammation may or may not be present. The pain may be severe at times, followed by periods of relative relief. It often worsens after extensive use of the knee and is more likely to occur at night than in the morning. Stiffness tends to follow periods of inactivity, such as sleep or sitting and can be eased by stretching and exercise. Pain also seems to increase in humid weather. As the disease progresses, the pain may occur even when the joint is at rest and can keep the sufferer awake at night.