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Patella problems: pain, instability, dislocation.

Many people suffer from patellar pain: it is localized on the front of the knee, and is often triggered by the descent of a slope or stairs; they can become very embarrassing in the practice of various sports, and even in the banal gestures of daily life.

In many cases, it is quite simply a muscular insufficiency which causes these pains, and it is enough to do strengthening exercises of the quadriceps (large muscle located on the front of the thigh).

For example, sitting on a table with your legs dangling. Bend the knee to approximately 30 degrees, and from this position raise the leg in extension 10 x in succession; do the same on the other side, etc. you can also add a weight on the foot (plastic bag with 1 or 2 dictionaries, for example). Rope jumping is also excellent.

At best, exercise or cycle regularly.


Sometimes the pain resists intensive weight training. It is then necessary to investigate, to find out if there is a bone or joint deformation that causes the pain.

Patella deformation:  in some people, the patella does not develop quite normally:

Above: The patella, seen in enfilade, shows a tendency to move the knee outwards.

This is due to the patellar fins: these are the ligaments that hold the kneecap on either side.

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Above, the external patellar fin is retracted, causing excessive pressure on the outside, and therefore pain; the internal wing is released.

The simplest operation is the section of the external aileron associated with a kink of the internal aileron:

On the left, the external patellar aileron has been sectioned, and a plication of the internal aileron is performed; on the right, the threads of the internal fin have been firmly tied, which has allowed the ball joint to be returned to its rightful place.


In some cases, it is the axis of the patellar tendon that is deviated outwards: it is then necessary to move its insertion on the top of the tibia inwards, to obtain a recentering of the patella (Elmslie-Trillat operation).

Above, left, patellar axis deviated outside; on the right, axis correction by internal displacement of the insertion of the patellar tendon on the tibia; the displaced piece of bone is fixed by screws (two small circles in the drawing).

After one  traumatic dislocation  of the patella, it is sometimes necessary to operate, to reconstruct the internal wing which has just broken, in order to prevent subsequent spontaneous dislocations.

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