Exploring Distal Realignment Procedures

If you’re experiencing chronic dislocation or instability in your kneecap (patellofemoral instability), distal realignment procedures might be the solution you need. These surgeries focus on repositioning the structures of your kneecap, specifically adjusting the tendon beneath it to align better with the tibial tubercle, the bump on your shin bone just below the knee.

doctor feeling a patient's knee

What is distal realignment?

Distal realignment is a surgical procedure aimed at correcting patellofemoral instability – the chronic misalignment or dislocation of the kneecap. This operation repositions the structures around your kneecap, particularly the tendon under the kneecap, to better align with the tibial tubercle on your shin bone.

This realignment helps stabilize the kneecap, alleviating issues like pain, a sensation of looseness, and knee buckling that you may experience during movement. This procedure may be advised by our knee specialists when non-surgical treatments have not led to significant relief. It is especially beneficial if you have a history of knee injuries or an anatomical predisposition causing your kneecap to track improperly.

Are you a candidate for a distal realignment procedure?

You may need this procedure if you have patellar instability, often resulting from a partial dislocation in your knee (subluxation). Symptoms include knee pain, a feeling of looseness in the kneecap, and knee buckling. This issue often arises due to injury or anatomical factors that cause the patella to track off to the side. Conservative treatments like activity modification, quadriceps-strengthening exercises, and wearing a knee brace can sometimes manage patellofemoral instability. However, if these don’t significantly relieve your symptoms, surgery might be necessary.

Types of distal realignment procedures

Several variations of this surgery exist, each tailored to your specific needs. Your surgeon will decide the best approach for you, considering how your tendon and tibial tubercle should be moved and altered within the knee. Some common types include the Maquet, Elmslie-Trillat, Fulkerson, Hauser, and Roux-Goldthwait procedures.

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What is the procedure?

Performed under general anesthesia, the surgery typically takes 60 to 90 minutes. It involves an incision in the lower front of your knee, repositioning the tibial tubercle and patellar tendon, and securing the adjusted bone with metal screws. Recovery may require a short hospital stay.

Recovery from a distal realignment procedure

Post-surgery, you can expect some pain and swelling, which respond well to elevation and ice. You’ll need a cast or knee immobilizer for support, along with crutches or a cane for up to six weeks. Physical therapy is crucial for regaining strength and functionality. Sedentary work might be possible after a few days, but physical jobs and activities typically need a longer break.

Why choose us?

At New York Sports & Joints, you will be under the care of a team of highly skilled surgeons specializing in distal realignment procedures. Each of our surgeons is board-certified and boasts extensive experience in orthopaedic surgery, with specific expertise in addressing patellofemoral instability. They have trained at top medical institutions and are well-versed in the latest surgical techniques, ensuring that your procedure is as effective and safe as possible. We pride ourselves on providing personalized care, understanding that each case is unique.

From your initial consultation to your final follow-up, our team is dedicated to guiding you through every step of your journey with professional expertise and compassionate care. Choosing us means entrusting your knee health to experts who are committed to achieving the best possible outcomes for you.

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Distal Realignment Procedures FAQ

What conditions does distal realignment treat?

Distal realignment is primarily used to treat patellofemoral instability, which includes chronic dislocation or misalignment of the kneecap. It’s particularly effective for those who experience recurrent kneecap issues due to anatomical factors or previous injuries.

How is distal realignment different from other knee surgeries?

Unlike total knee replacements or ligament repairs, distal realignment specifically targets the alignment of the kneecap. It involves repositioning the tendon beneath the kneecap and the tibial tubercle to correct the patella’s tracking within the knee joint.

What can I expect during recovery from a distal realignment procedure?

Post-surgery, you’ll likely experience some pain and swelling, managed with medication, elevation, and ice. You’ll need a knee immobilizer or cast and will use crutches or a cane for several weeks. Physical therapy is crucial for regaining strength and motion, with full recovery taking several months.

Are there risks associated with distal realignment procedures?

As with any surgery, there are risks, such as infection, prolonged healing, pain, and a potential decrease in the knee’s range of motion. Your surgeon will discuss these risks with you in detail to ensure you make an informed decision.

Will I be able to return to sports after a distal realignment procedure?

Many patients successfully return to sports and physical activities post-recovery. However, the timeline and extent of your return to these activities will depend on your body’s natural healing processes, along with assistance from our sports medicine specialists.

Are there any risks?

While generally safe and effective, there are some risks, including infection, pain, prolonged bone healing, and decreased knee motion range. It’s important to discuss these with your surgeon to make an informed decision.

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