The knee-cap (patella) is a small bone situated on the underside of the quadriceps tendon which crosses the front of the knee. The bone is shaped to fit inside a groove (the trochlea) on the end of the thigh bone (femur), and glides through the groove as the knee bends and straightens.
Occasionally the soft structures, such as the capsule, ligaments or tendons around the knee can become tight, or the muscles can become weak and imbalanced causing the knee-cap to move irregularly in the groove. Most commonly the knee-cap or patella tends to be pulled to the outside, this is known as “lateral tracking”, and can cause severe symptoms including pain, particularly on stairs, and giving way. If untreated this may lead to abnormal wear on the joint surfaces and eventually osteoarthritic changes may occur.
A “lateral release” involves a small internal incision being made through the tight bands in the capsule, thus allowing the patella to move back to the correct position. This procedure is carried out arthroscopically from the inside. Appropriate post-operative physiotherapy is imperative to regain normal muscle balance and strength.
The release will eventually heal so your physiotherapist will show you how to move your kneecap to prevent the scar tissue becoming tight and inflexible, otherwise a recurrence of symptoms is possible.