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

What should I expect when I come to hospital?

Following your appointment with Mr Moss, his practice manager Niki Bassett will get in touch to offer you a convenient date and time for admission. Following this discussion you will have an hour-long appointment with our pre-assessment nursing/physiotherapy team. This will be to discuss medical history, medication, recovery after surgery, equipment you may need, home circumstances and any worries you may have regarding your treatment. The nurse will liaise with Mr Moss’s anaesthetist regarding your test results. If the anaesthetist is concerned about your medical history he may ask you to attend another appointment to see him in clinic.

On the day of admission you will be taken to your room by one of our receptionist team. The nurse in charge of your care will confirm your medical history and check your medication has not changed since your pre-assessment appointment. You will then be prepared for theatre. Mr Moss and his anaesthetist will see you prior to theatre to explain fully what they will be doing and consent with be obtained.

Following surgery you will continue to be looked after in your own room by the nursing and physiotherapy staff.

Mr Moss or his anaesthetist will review you on a daily ward round. You will be visited daily by our resident medical doctor who is on-call to answer any questions. You will also be visited by our pharmacist to ensure the pain medication is suitable for you.