Patella Fracture and Instability Singapore

Non-Surgical Treatment

Non-surgical treatment may be recommended when fractures are stable or when patella instability can be managed without reconstruction.

• Immobilisation with brace or cast: Your knee is kept straight and protected in a brace or plaster cast for several weeks to allow the bone to heal in the correct position
• Pain management medication: Prescribed medications help control pain and reduce swelling during the initial healing period
• Physical therapy: Structured exercises help restore knee movement, strengthen surrounding muscles, and improve stability once initial healing has occurred

Surgical Treatment

Surgery may be required for displaced fractures, recurrent instability, or failure of conservative treatment.

• Open reduction and internal fixation: The broken pieces of your kneecap are repositioned and held together with screws, wires, or pins to allow proper healing
• Medial patellofemoral ligament (MPFL) reconstruction: A torn or stretched ligament that normally keeps your kneecap in position is rebuilt using a tendon graft
• Tibial tubercle osteotomy: The bony attachment point of your patellar tendon is repositioned to improve kneecap alignment and reduce instability
• Arthroscopic repair of the MPFL: A minimally invasive procedure to directly repair a torn MPFL without the need for a full reconstruction.
• Arthroscopic patellar realignment: A keyhole surgical approach to correct the position of a dislocated or unstable kneecap, helping it track more effectively in its groove.
• Trochleoplasty: This complex procedure reshapes the trochlear groove of the femur, creating a deeper channel to guide the kneecap and prevent it from slipping out.
• Treatment of recurrent patellar dislocation: A tailored approach that may involve a combination of the above techniques to address chronic kneecap instability and prevent future dislocations.

Transverse fractures

A horizontal break across the kneecap, often caused by sudden muscle contraction and typically the most common type of patella fracture

Comminuted fractures

The kneecap breaks into multiple pieces, usually resulting from high-energy impacts such as car accidents or severe falls

Displaced fractures

Broken pieces of the kneecap separate and move apart, which can disrupt the normal mechanics of your knee joint

Non-displaced fractures

The kneecap cracks but the pieces remain in their normal position, often allowing for better healing outcomes

Acute patella dislocation

The kneecap suddenly moves completely out of its groove, usually to the outside of your knee

Chronic patella instability

Ongoing problems with the kneecap slipping partially or completely out of position, often following previous dislocations

How long will I need to use crutches after a patella injury?

The duration varies depending on your specific injury and treatment, but most patients use crutches for 4-8 weeks following a fracture or major dislocation. Your doctor will guide you through gradually increasing weight bearing as healing progresses.

Can a dislocated kneecap cause permanent damage?

Whilst most people recover well from patella dislocations, repeated dislocations can damage the cartilage surface of your kneecap or thighbone, potentially leading to ongoing problems. This is why addressing chronic instability is often recommended.

Will I have a visible scar after patella surgery in Singapore?

Most patella surgeries require an incision at the front of your knee, which typically heals to leave a straight scar of about 8-12 centimetres. The appearance of scars varies between individuals and tends to fade over time.

What happens if I ignore patella instability?

Untreated patella instability often leads to repeated dislocations, which can progressively damage the cartilage surfaces in your knee and may eventually require more complex surgical treatment. Early treatment typically yields better long-term outcomes.