Patellofemoral Surgery
Patellofemoral Surgery
Some patients experience significant knee pain or instability because the kneecap does not track properly within its groove. In some cases, the kneecap may feel loose or fully dislocate; in others, it rides along the edge of the groove, creating pain and increased joint stress that can ultimately lead to arthritis.
Dr. Petty has extensive experience treating patellofemoral conditions, including patellar instability and malalignment, most commonly in adolescents and young adults. Addressing these problems early—before significant arthritis develops— can relieve symptoms, restore stability, and help protect the in knee long term.
For patients with significant malalignment, Dr. Petty performs a tibial tubercle osteotomy, commonly referred to as a Fulkerson procedure. This technique involves carefully repositioning the patellar tendon attachment on the tibia to restore proper tracking of the patella and reduce damaging joint forces. In rare cases, an osteotomy to correct problems with the groove are also performed (Albee Osteotomy).
Individualized Surgical Approach
Dr. Petty’s approach emphasizes individualized surgical assessment and implementation. Each procedure is guided by detailed MRI measurements combined with a comprehensive in-office examination. Using precise mathematical calculations, he determines the optimal amount of tibial tubercle translation during surgery—most commonly approximately 10 mm—to achieve accurate alignment and durable results. This osteotomy plays a key role in restoring stability for patients with recurrent kneecap dislocations.
In some cases, patellar instability occurs without significant malalignment and is often the result of a traumatic dislocation during sports activity. When appropriate, these patients may be treated with a less invasive procedure known as medial patellofemoral ligament (MPFL) reconstruction. Dr. Petty has developed specialized, reliable techniques for MPFL reconstruction that effectively restore stability while preserving normal knee motion.
