Avoiding and Managing Complications in Patella Surgery

Afflictions of the patellofemoral joint are one of the most common conditions that the Sports Medicine Orthopedist will encounter in his practice. Anterior knee pain has many causalities, is often poorly understood, misdiagnosed, and, as a consequence, is often mistreated. Many consider anterior knee pain to be the “back pain” of the Sports Medicine Specialist. The etiology of the pain is often poorly understood, frequently leading to multiple operations that culminate in an unhappy patient as well as a frustrated physician. Although this chapter is focused on avoiding, managing, and treating complications in patellar surgery, the vast majority of patients with patellofemoral conditions should be managed with nonoperative measures. Rehabilitation is just about always at the top of the list in the vast majority of patellofemoral injuries and disorders. The patellofemoral joint is one of the most common areas where surgery can often make the patients worse rather than better and should be approached very carefully. In this chapter, we will focus on patellofemoral realignment and instability surgery. Over 100 operations have been described for the management of recurrent lateral patellar instability and, although there are many surgical methods to treat the same condition, performing the wrong operation can lead to a disastrous result. Select the operation wisely. This often requires multiple office visits to become acquainted with your patient physically as well as psychologically.