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- Sun Nov 15, 2009 5:36 pm
My doctor has recommended a release of the lateral ligament in my knee to correct a patella problem. I develop pain in both knees and it seems that it is a result of the patella being offset. My doctor says it likely a condition that I was born with. I would like to understand the long term effects of the ligament release surgery. I would also like to know if there any alternative procedures and the pros/cons of that.
I have been active in sports most of my life but had not had any issues with my knees until recently. Seven months ago I had surgery to remove 30% of the medial meniscus due to a tear. I have re-injured the same knee which will require a second surgery to repair a tear of the lateral meniscus.
| Dr.M.Aroon kamath
- Wed Dec 09, 2009 8:53 pm
The structure of the knee is complex, and management of patello-femoral malalignment can be equally so.
Re-alignment of the structures of the knee joint including the patello-femoral joint involves realigning
- the forces within the joint and
- the forces outside the joint.
Perfect alignment throughout the arc of flexion and correct varus-valgus alignment in all positions of flexion is the hall-mark of a normal knee joint and this is what is aimed at while managing malalignment.
Reliable anatomical landmarks are required for surgical re-alignment (both in flexion and extension). Highly reliable landmarks are the long axes of the femur and tibia and the AP (anterior-posterior) axis of the femur and provide the guidelines for establishing stable alignment of the joint surfaces by placing the tibia and patellar groove correctly in the median anterior-posterior plane throughout the entire arc of flexion.
Ligaments perform specific functions, and these functions differ in different positions of knee flexion. Knowing their function and testing their tension clinically provides the information needed to plan release only the ligaments that are excessively tight.
Ligament release is not believed to cause instability of the knee. Failure to align the knee and release the tight ligaments, however, does cause excessive wear and tear,instability,and unreliable function.
In your case, there seem to be multiple problems (a previously repaired medial meniscus, a recently torn lateral meniscus + possible patellofemoral malalignment).
Your orthopedic surgeon will be the best person to decide if non-operative means or surgery is the best option for you.