Restoring Stability in Chronic Patellar Instability – A Combined Surgical Approach in a Young Active Patient
A real patient story of how recurrent kneecap dislocation was permanently fixed at Continental Hospitals, Hyderabad by Dr. Arun Reddy Mallu, a distinguished orthopaedic & robotic knee replacement surgeon at Continental Hospitals. The Problem: A Kneecap That Wouldn’t Stay in Place Imagine this. You’re 29 years old. You’re walking around your house. You bend your knee slightly and suddenly; your kneecap slides out of place. The pain is sharp. You can’t walk properly. And you’re left wondering – why did this happen again? That was Priya’s life. (Name changed.) For almost 3 years, her right kneecap kept dislocating, slipping out of its place again and again. Not because she fell. Not because of any accident or sports injury. It just happened on its own, without any warning. And every time it happened, the fear got worse. She started changing the way she lived: She stopped playing sports entirely. She began walking slowly and carefully always scared the knee would give way. Simple daily activities climbing stairs, going to the market became stressful. Her confidence dropped. Her independence was slipping away. She had already visited multiple hospitals. She had tried physiotherapy and medicines. But nothing worked for long. The kneecap would dislocate again, and the whole painful cycle would start over. That’s when someone guided her to Continental Hospitals, Hyderabad and to Dr. Arun Reddy Mallu. “Why Does Kneecap Keep Dislocating?” – The Real Answer This is the most common question patients with recurrent kneecap dislocation ask. And most of them have never received a proper answer. When Priya came to Dr. Arun Reddy Mallu, he didn’t just look at her knee. He looked deeper – at the structure of her knee, the shape of her bones, and the condition of her ligaments. After a thorough examination and detailed imaging, three separate problems were found – each one making her kneecap instability worse: 3 Reasons Her Kneecap Kept Dislocating Reason 1: The Groove in Her Knee Was Too Shallow Think of the kneecap like a ball sitting inside a bowl. Normally, the bowl is deep enough to keep the ball in place. In Priya’s case, the bowl was almost flat. So the kneecap had no real support — it could slide out very easily. Reason 2: Her Kneecap Was Sitting Too High Her kneecap was positioned slightly higher than normal. This meant it took too long to settle into the groove when she bent her knee – leaving it unstable and vulnerable during everyday movements. Reason 3: A Torn Inner Ligament There is a ligament on the inner side of the knee that acts like a seatbelt for the kneecap -stopping it from sliding outward. Priya’s was torn and not working. Without it, there was nothing to stop the kneecap from popping out. This is why previous treatments had failed. They were addressing only one problem at a time – or not addressing the bone structure at all. A partial fix was never going to work here. All three problems needed to be corrected together in a single surgery. The Surgery: Fixing the Bone and Rebuilding the Ligament Dr. Arun Reddy Mallu designed a clear plan: fix the root cause, not just the symptoms. The surgery had two parts – both performed together in a single operation. Here’s what happened, explained simply: Part 1 – Moving the Kneecap Anchor to the Right Position The kneecap is connected to the shin bone by a strong tendon. The point where this tendon attaches to the shin bone was in the wrong position – it was pulling the kneecap sideways and upward. Dr. Arun Reddy Mallu moved this attachment point slightly downward and slightly inward to bring the kneecap to the correct position, so it could sit properly inside the groove. Small orthopaedic screws were used to hold the bone in its new position. This is called kneecap realignment surgery and it directly corrects the structural problem that was causing the kneecap to dislocate. Part 2 – Rebuilding the Torn Inner Ligament The torn inner ligament – the kneecap’s natural seatbelt was completely rebuilt. A small tendon from the back of Priya’s own thigh was used as a replacement. This is her own natural tissue it bonds well with the knee and becomes a permanent part of the joint. This rebuilt ligament now acts as a strong check on the kneecap. Every time the knee bends and straightens, the ligament keeps the kneecap from sliding outward. This is called MPFL reconstruction – one of the most effective treatments for recurrent kneecap dislocation. Together, these two procedures gave Priya’s knee what it had been missing for 3 years: a proper bone structure to hold the kneecap in place, and a strong ligament to keep it there. AP View (Front View) Lateral View (Side View) Postoperative X-rays showing screw fixation and successful bone realignment after kneecap stabilisation surgery The Week by Week Recovery: Priya started physiotherapy within days of the surgery. Her recovery was structured, supervised, and steady. Recovery Week What Happened Week 1 – 2 Pain was reducing. Started gentle movement and light exercises. Week 3 – 4 Walking with support. Knee felt noticeably more stable. Week 5 – 6 Walking without any support. No dislocation episode at all. Week 7 – 8 Walking normally. Zero pain. Zero fear. Full confidence restored. At the 8-week follow-up appointment, the results were clear. The kneecap had not dislocated even once since surgery. Her range of motion was completely restored. She was walking normally – no guarding, no fear, no support needed. Postoperative photograph showing early knee bending achieved within days of kneecap stabilisation surgery In 8 weeks, she went from being afraid to walk across a room to living her normal life again. 8-Week Post-Op Recovery — Patient Walking Without Support After MPFL Reconstruction. Before Surgery vs. After Surgery: The Full Transformation Before Surgery After Surgery (8 Weeks) Kneecap dislocating repeatedly Zero dislocations after surgery Walking in fear, guarded every step