Did she have patella realignment or some form of distal femoral / upper
If it was patella realignment we had an interesting talk from a surgeon from
Norfolk & Norwich Hospital, England, called Simon Donnell. He talks of there
often being a problem with the boss, an articular section of the trochlear
notch that is sometimes convex rather than concave. This can then result in
problems with the patella engaging in the trochlear. I have a patient who
has bilateral problems and had numeroous operations, ultimately leading to a
patellectomy on one side and still gets problems, mainly of instability.
Simon's comments on her case was to perform a notchplasty whereby lowering
the boss and forming a correct groove. Initially he would go for the
patellectomy side! She's decided to persevere at present!
I believe the french are big into these problems.
I would look closely at any lateral xrays you can see and see if the
trochlear looks odd - it's difficult to describe!
Hope this is useful
From: - for physiotherapists in education and practice
[mailto:[log in to unmask]]On Behalf Of Henry Tsao
Sent: 06 October 2001 10:47
To: [log in to unmask]
Subject: knee locking
I have a girl who was referred to me over 3/12 ago following surgery to her
right knee (realignment). She has recovered well, but has continued to
complain of locking in her knee between 30-60 degrees. She is able to unlock
it herself, but has pain in the medial patella region. Does anybody know
what this may be, and how to manage this symptom?
thank you in advance :)
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