Q. My 16-year-old daughter first dislocated her kneecap two years ago playing soccer. Since that time it has popped out at least twice more. She saw an orthopedic doctor who told her she could do physical therapy, but would likely have to give up sports unless she had surgery. She wants to stay active, but doesn't want surgery. What should we do?
A. Problems with kneecaps are very common, particularly in teenage women. After a first-time traumatic dislocation, there is at least a 50 percent redislocation rate even with ideal non-surgical treatment.
Since your daughter was not treated after the initial dislocation and has had at least three dislocations in total, it is likely that surgery will be necessary. Surgery would involve realigning the kneecap and reconstructing the medial patella femoral ligament, which is important in stabilizing the kneecap. Technology has improved a lot and many of these procedures can be performed minimally invasive.
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After surgery there would be a period of bracing followed by an extensive physical therapy program to aid in kneecap tracking and stability. Kneecap surgery is technically demanding. I recommend you find an orthopedic sports medicine specialist with experience.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net.