If patellar instability is severe or chronic, surgery might be necessary. The type of surgery depends on the cause of the instability:

• MPFL/LPFL Reconstruction: If the problem is due to a torn or stretched ligament, surgery can rebuild these ligaments to help keep the kneecap in its proper place.
• Osteotomy: If the bones are not aligned properly, this surgery can realign them to prevent dislocations.
• Trochleoplasty: If the groove where the kneecap sits is too shallow it can be deepened to better support the kneecap.
• Cartilage Repair: If there is damage to the cartilage, surgery can help reposition the kneecap decreasing pressure, which can reduce pain.
• Arthroscopy: This procedure using a camera in the joint to fix or remove loose cartilage fragments and improve knee stability.

After MPFL or LPFL surgery, you can expect:

• Weight-Bearing: You can put weight on your leg using crutches as pain allows.
• Knee Brace: You will need to wear a hinged knee brace for about 6 weeks. Initially, the brace will keep your knee straight.
• Physical Therapy: Starts right after surgery to help regain movement and strength. The therapy will focus on gradually increasing the knee’s range of motion over 6 weeks, following a specific protocol.
• Recovery Time: Full recovery usually takes between 5 to 6 months.

Physical therapy is a key part of the recovery process, helping you get back to normal activities and strengthening the knee.