Patellar Instability Surgery

The kneecap (patella) moves smoothly within its groove on the femur when bending or straightening the knee. However, after a hard blow or fall, it can dislocate partially or fully, causing pain and loss of knee function. Even if the kneecap returns to position naturally, a doctor’s evaluation is necessary to check for soft tissue or joint damage and provide appropriate treatment.

There are various reasons why a child’s kneecap might become unstable or dislocate. Sometimes, even minimal force can cause this due to abnormalities in the knee’s structure. For instance, a shallow or uneven groove in the femur may not securely hold the patella in place. Children with loose ligaments or extremely flexible joints are more prone to dislocations, a condition often seen in girls and sometimes affecting both knees.
In children with healthy knee structures, patellar dislocations frequently result from direct trauma or falls, particularly during high-impact sports like football. Non-contact injuries can also cause dislocations, such as during a baseball swing, where rotational forces on the leg can cause the patella to dislocate.

When the patella dislocates, symptoms vary depending on the severity. Common signs include pain, a sensation of the kneecap shifting, knee buckling, a popping sound during dislocation, swelling, visible deformity, and apprehension when moving or changing direction.

For nonsurgical treatment of patellar dislocation, your child’s doctor will likely recommend wearing a knee brace for 3-4 weeks to keep the knee stable while it heals. If your child’s patella dislocates multiple times or remains unstable despite bracing and therapy, surgery may be necessary. The exact type of surgery will depend on whether the problem stems from ligament issues, structural abnormalities, or bone deformities. One common approach is ligament reconstruction, where damaged or weak ligaments are repaired to better hold the patella in place. This procedure can often be performed arthroscopically, meaning that the surgeon uses a small camera and precise instruments through tiny incisions, minimizing recovery time and scarring. However, if the cause of the instability is a congenital defect or significant bone deformity, more complex surgery may be required to address the issue properly.

Candidates for patellar instability surgery are usually children who experience repeated or chronic patellar dislocations, despite undergoing conservative treatments like physical therapy, bracing, and immobilization. Surgery is considered when the knee remains unstable, affecting daily activities or athletic performance. In some cases, children with specific anatomical abnormalities such as a shallow femoral groove or loose ligaments may be more likely to require surgery. Additionally, children with congenital conditions or other bone deformities that contribute to patellar instability may also be suitable candidates for surgical intervention. The goal of surgery is to provide long-term stability and prevent further damage to the knee joint.

Patellar instability repair surgery involves a femoral or tibial osteotomy, where a portion of the bone is cut and repositioned to improve the alignment of the patella. A lateral release can also be performed where the tight ligaments on the outside of the knee are released to allow the patella to move more freely within its groove. In cases where the ligaments that stabilize the patella are damaged or too weak, the surgeon may perform a ligament reconstructionusing tissue grafts.

The procedure is performed under general anaesthesia to ensure that the child is fully unconscious and pain-free throughout the procedure. Regional anesthesia, for example a femoral nerve block, may also be used in combination with general anesthesia to provide additional pain relief, especially post-operatively.

The surgery typically takes 1 to 2 hours, depending on the complexity of the procedure and the specific technique used. Soft tissue realignment may be quicker, while osteotomy or ligament reconstruction may take longer.

• After the procedure, paediatric patient will be monitored in the recovery room when she/he comes round from anaesthesia.
• The recovery time can vary, but most children begin physical therapy within a few weeks to regain motion and strength.
• Regular follow-up visits with the surgeon are essential to monitor healing, ensure proper knee alignment, and adjust treatment if necessary.
• Full recovery may take anywhere from 6 weeks to several months, depending on the surgical technique and the child’s adherence to the rehabilitation plan.

• Medications will be prescribed to manage post-surgical pain. Patients should follow the prescribed schedule to prevent discomfort.
• After surgery, the knee may be placed in a brace or splint to limit movement and promote healing. This is typically worn for a few weeks as directed by the surgeon.
• To reduce pressure on the knee, crutches will be recommended for the first few weeks. Weight-bearing is generally avoided to prevent strain on the surgical site.
• Swelling is common after surgery. Elevating the knee and applying ice can help reduce swelling and speed up recovery.
• At Prospero Medical, we provide follow-up care for up to 6 months to 1 year post-surgery. Patients should report any issues directly to our clinic for timely assistance before consulting other specialists.

Turkey is not only a top-performing country in a wide range of medical disciplines, but also a fascinating destination known for its rich historical heritage and warm hospitality. This combination makes Turkey a unique hotspot for various treatment options, including patellar instability repair surgery. Having surgery in Turkey offers several benefits, some of which may even outweigh those of undergoing the same treatment in one’s home country. These benefits include:

• High level of medical expertise and well-established medical scholarship.
• State-of-the-art private hospitals utilizing high-precision technology.
• Personalized after-care infused with the distinct flavor of Turkish hospitality.
• Competitive pricing based on a value-for-money equation.
• A perfect setting for recovery, where orthopedic treatment packages are often combined with physiotherapy sessions to expedite the recovery process.

When choosing the right clinic for surgery, there are several critical factors to consider, especially amid the overwhelming presence of commercial advertisements and social media promotions. The guiding criteria for shortlisting a clinic should include:

• Truthful medical advice that is free from commercial interests.
• A genuine effort to establish rapport with the patient, understanding their concerns and managing expectations with empathy and professionalism.
• Prioritizing patient well-being and safety above all else.

For a realistic price estimation or financial appraisal of the treatment, the following aspects should be carefully reviewed:

• The professional standing of the clinic, including its reputation in the medical community.
• The nature of the procedure and its complexity, as this influences both the treatment cost and expected outcomes.
• The credentials of the surgeon and the quality of the after-care services provided by the clinic.
• A clear understanding of the terms and conditions, where clinical liabilities are laid out impartially in proper legal format, ensuring transparency and security for the patient.

Patellar instability repair prices in Turkey can vary based on the factors mentioned above. While cost is often a significant motivator for seeking treatment abroad, it is essential to balance price with quality. Prioritizing cost over quality may lead to serious and potentially irreversible complications, which can be more expensive in the long run. At Prospero Medical, we are committed to transparent pricing, ensuring that each service component is clearly outlined to help patients make informed decisions about their surgical treatments. Our goal is to provide a pricing structure that reflects the high level of medical service, the expertise of the surgeons we collaborate with, and the comprehensive after-care services we offer. With years of experience and a well-established presence in the industry, we are dedicated to offering high-quality medical services that are aligned with a realistic and fair price.