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KNEECAP REALIGNMENT •If the kneecap is malaligned, the first choice of treatment is always conservative •If conservative treatment is not helpful, surgery is sometimes considered. RELEASING TISSUE •One way of realigning the kneecap is to release tissue on the outside of the knee this is called a lateral release •This surgery is somewhat controversial, but can be effective MOVING A QUADRICEPS MUSCLE •If the kneecap is unstable, structures on the inside of the knee can be tightened •This helps realign the kneecap SHIFTING THE ATTACHMENT •If the kneecap is severely malaligned, moving the attachment of the kneecap tendon on the shinbone can be considered •In this surgery, the attachment on the shinbone is moved to the inside to realign the kneecap Orthopedic Institute 1151 Hospital Way, Building D • Pocatello, ID 83201 98 Poplar Street, 3rd Floor • Blackfoot, ID 83221 (208) 239-8010 • www.EastIdahoOrtho.com PATELLA PAIN THE KNEECAP AND KNEE JOINT The Quadriceps are the big muscles in front of the thigh. These attach to the kneecap (patella) via the quadricep tendon. The kneecap (patella) allows the quadriceps to straighten the leg more effectively. THE KNEECAP IN ACTION •The kneecap sits in the groove on the front of the thigh bone, and normally moves smoothly •In some people, the kneecap is malaligned, and does not sit properly in the groove PATELLAR TENDINITIS •The patellar tendon connects the kneecap to the shin bone •In some cases, this tendon can become inflamed and painful •Treatment for this condition is almost always conservative, using physical therapy, bracing, and modification of activity PLICA BAND SYNDROME •A plica band is a remnant of knee development in infancy. Occasionally this can cause pain in adolescents or adults •In some cases, surgery is considered CARTILAGE DAMAGE •Cartilage damage can be caused because of wear and tear or injury •Often times this leads to pain and grinding under the kneecap DISLOCATION •In some cases, the kneecap slips out of the groove and can cause pain, soreness and swelling •This can often be treated with physical therapy •If this becomes a persistent problem, surgery can be considered