Patella stabilisation

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Reviewed on Tuesday 21 April 2026 by Mr Nick Boyce Cam, Consultant Orthopaedic Surgeon

Patella stabilisation is a surgery to fix a kneecap (patella) that keeps slipping out of place. By realigning the patella and securing it in its proper position, this surgery helps prevent future dislocations and improves overall knee function.

What is patella stabilisation surgery?

Patella stabilisation surgery, also known as kneecap stabilisation or patella realignment surgery, is an operation to correct an unstable kneecap (patella) that repeatedly dislocates or partially dislocates (subluxation).

How the patella functions

The patella, or kneecap, is a triangular bone that sits in a V-shaped groove (the trochlear) at the front of the thigh bone (femur).

The kneecap is attached to the quadriceps tendon, which connects your thigh muscles to the top of the kneecap, and the patellar tendon, which connects the bottom of the kneecap to your shin bone (tibia).

To keep the kneecap stable, the medial patellofemoral ligament (MPFL) prevents the kneecap from slipping outwards and popping out of its track, especially during movement.

As you bend or straighten your knee, the patella should glide smoothly up and down within the trochlear groove – a process known as patellar tracking. If the MPFL, tendon or muscles are damaged or not working properly, the kneecap can become unstable and partially (subluxate) or fully dislocate out of the groove.

This can cause pain, swelling and a feeling that your knee may give way or buckle. It can make it difficult to fully straighten the leg or put weight on your knee comfortably.

What causes patella instability?

Patella instability occurs when the patella (kneecap) shifts out of the trochlear groove:

  1. Traumatic injury: A sudden twist, fall or direct blow can force the kneecap out of its groove — either completely (dislocation) or partially (subluxation). This can damage the ligaments that normally hold the kneecap in place, particularly the medial patellofemoral ligament (MPFL), increasing the risk of recurrent dislocations.
  2. Structural instability: For some people, the shape or alignment of their knee may cause patella instability. For example, the trochlear groove in the femur (thigh bone) may be shallower than usual, or the kneecap may sit too high on the femur. This makes the kneecap more prone to slipping out of the trochlear groove during movement. Loose knee ligaments or hypermobility (extremely flexible joints) can also cause patella instability.

Is patella stabilisation surgery right for me?

Your consultant may recommend patella stabilisation surgery if:

  • You have repeated patella dislocation.
  • You have a persistent feeling that your knee is going to buckle or give way.
  • You have tried non-surgical options such as physiotherapy and bracing, but your symptoms have not improved.
  • You have ongoing pain and limited movement.
  • You have a problem with the structure or alignment of your knee — for example, a torn medial patellofemoral ligament (MPFL), tendons not lining up properly or a shallow trochlear groove.

What happens during patella stabilisation surgery?

Patella stabilisation surgery usually takes around 60 to 90 minutes and is performed under general anaesthesia.

The type of surgery performed is based on your knee anatomy or injury:

1. Medial Patellofemoral Ligament (MPFL) repair

Your surgeon will repair or tighten the torn medial patellofemoral ligament (MPFL) by reattaching it to the bone using suture anchors (small screws that have high-strength threads attached to them). This helps to restore stability and keeps the kneecap (patella) in the correct position.

2. Medial Patellofemoral Ligament (MPFL) reconstruction

Your surgeon will reconstruct the torn medial patellofemoral ligament (MPFL) by replacing it with a graft. The graft is usually taken from one of your own hamstring tendons (autograft), but in some cases, a donor tendon (allograft) may be used.

The graft is fixed to the inside of the kneecap and the femur (thigh bone), recreating the ligament and helping to keep the kneecap stable and in the correct position.

MPFL reconstruction is the most used patella stabilisation procedure.

3. Tibial tubercle osteotomy (TTO)

In some cases, tight tissues on the outside of the knee can pull the kneecap out of place. A lateral release involves cutting these tight tissues to allow the kneecap to sit more centrally in the trochlear groove.

MPFL repair, MPFL reconstruction and lateral release are often performed through small incisions, but tibial tubercle osteotomy (TTO) is performed as open surgery.

4. Lateral release

In some cases, tight tissues on the outside of the knee can pull the kneecap out of place. A lateral release involves cutting these tight tissues to allow the kneecap to sit more centrally in the trochlear groove.

MPFL repair, MPFL reconstruction and lateral release are often performed through small incisions, but tibial tubercle osteotomy (TTO) is performed as open surgery.

Preparing for kneecap stabilisation surgery

Your consultant (surgeon) and the healthcare team will give you instructions on how to prepare for surgery, and it is important to follow them carefully.

  • Stop taking medication: You may have to stop taking certain medications, such as blood thinners, before and after your surgery. Please tell your consultant and pre-assessment nurse about all the medications you are taking, including prescription medications, over-the-counter drugs, and supplements.
  • Exercising: Do some gentle exercises before your surgery to strengthen the muscles around your knee and help with your recovery.
  • Stop smoking or vaping: If you smoke or vape, stop several weeks before the operation, as nicotine can affect wound healing.
  • Arrange transportation: You will not be able to drive after surgery, so make sure someone can pick you up from the hospital and take you home.
  • Fasting: Be sure to follow any instructions for fasting before your surgery (usually no food or drink for several hours before your surgery).

During the procedure

  • MPFL repair
    1. Your surgeon will make small cuts (incisions) on the inner side of the knee to access the torn ligament.
    2. Using a tiny camera (arthroscope), your surgeon will find exactly where the ligament is torn.
    3. Your surgeon places tiny suture anchors into the bone at the site of the tear. These are small, permanent screws that have high-strength threads attached to them.
    4. The threads from the anchors are looped through the loose end of your MPFL. The surgeon pulls these threads tight to secure it back to the bone.
    5. Your surgeon will gently move your knee through its full range of motion to make sure the kneecap is stable and tracking correctly.
    6. The incisions are closed with dissolvable stitches or clips, and a bandage is applied.
  • MPFL reconstruction
    1. Your surgeon will make a small cut (incision) to harvest a piece of healthy tissue (graft) to act as your new ligament. This is usually taken from your hamstring tendon, but a donor tendon (allograft) may also be used.
    2. Your surgeon will make small incisions around the knee to access the patella (kneecap) and femur (thigh bone).
    3. The graft is passed through tunnels in your femur and patella to recreate the MPFL.
    4. Your surgeon moves your knee through its full range of motion to check that the tension is perfect in the new MPFL, and the kneecap stays in place.
    5. The graft is fixed in place using permanent screws or anchors.
    6. The incisions are closed with dissolvable stitches or clips, and a bandage is applied.
  • Tibial tubercle osteotomy (TTO)
    1. Your surgeon will make a vertical incision (cut) over the front on your shin bone, just below the kneecap.
    2. Using a specialised surgical saw, your surgeon will cut into the tibial tubercle (the small bony area where the patellar tendon attaches) and remove a small piece of this bone away from the rest of the shin bone. The tendon remains attached to this piece of bone.
    3. Your surgeon will then place the bone into its new position.
    4. Your surgeon moves your knee through its full range of motion to check that the alignment and tracking of the kneecap is correct.
    5. Your surgeon will secure the piece of bone in its new position using screws.
    6. The incisions are closed with dissolvable stitches or clips, and a bandage is applied.
  • Tibial tubercle osteotomy (TTO)
    1. Your surgeon will make small cuts (incisions) around the knee and insert a tiny camera (arthroscope) to look inside the joint.
    2. They will check if the lateral retinaculum (a band of fibrous tissue on the outside of the knee) is too tight and pulling the kneecap out of alignment.
    3. Using a small surgical instrument or a specialised radiofrequency tool, your surgeon carefully cuts (releases) the tight lateral retinaculum.
    4. The surgeon moves your knee through its full range of motion checking that the kneecap now sits comfortably in the trochlear groove without tilting or sliding outward.
    5. The incisions are closed with dissolvable stitches adhesive strips, and a bandage is applied.


Recovery from patella (kneecap) stabilisation

Recovery at the hospital

You should be able to go home on the same day as your surgery. You will be given painkillers to help manage your pain.

You may be fitted with a knee brace to keep your kneecap in place whilst you heal. It is important to follow the instructions your consultant (surgeon) and healthcare team provide you regarding the knee brace. You may have to wear the brace for up to 6 weeks after surgery.

You will be encouraged to start walking as soon as it is safe after your surgery. A physiotherapist will show you how to walk using crutches. They will also give you exercises to help you regain your range of motion, strength and stability in your knee.

How much weight you can put on your knee will depend on the type of surgery you have. For example, if you have a tibial tubercle osteotomy (TTO), you may need to avoid putting weight on your knee for around 4 to 6 weeks while your bone heals. Your consultant and healthcare team give you specific guidance based on your procedure.

Recovery at home

Recovery from patella stabilisation surgery may take up to 6 weeks, depending on the type of surgical procedure you have, your general health and how well you follow aftercare instructions. However, improvements can be noticeable for up to 6 months.

Week 1
Weeks 2 -6
Weeks 6 - 12
Months 3 - 6+
You will likely need to use crutches to get around.

You may need to wear a knee brace to protect the knee.

Elevate the leg and apply ice for 15- 20 minutes to reduce pain and swelling.

You will be encouraged to do gentle exercises, such as ankle pumps and short walks around your home using your crutches.

Pain can be managed with pain relief medicine given by hospital staff or prescribed by your consultant.
Continue to use your crutches and wear the knee brace as instructed by your consultant and physiotherapist.

You may be able to put more weight on your leg and will start more intensive physiotherapy to build up the strength in your quadriceps and hamstrings.

Pain can be managed with over-the-counter painkillers.

Avoid driving until you can confidently perform an emergency stop (4-6 weeks).
You should be able to walk without crutches and will be able to return to low-impact activities like swimming and cycling.
You may be able to return to sport and other high-impact activities, but you should always get the all-clear from your consultant or physiotherapist first.

Physiotherapy is an essential part of your recovery because increasing your range of movement and building up strength in the muscles around the patella (kneecap) will help you get back to your normal activities.

What are the benefits of patella stabilisation?

The main benefits of patella stabilisation surgery are:

  • Improved knee stability: Patella stabilisation surgery can prevent your kneecap from dislocating in the future.
  • Reduced pain and swelling: By stabilising the kneecap, the surgery can relieve any pain caused by patella instability.
  • Improved knee function: You should be able to return to your normal daily activities and sports without the fear of your kneecap dislocating.
  • Increased confidence: Many people feel more confident in their knee after surgery, which can lead to a more active lifestyle.

How long do the benefits of patella stabilisation last?

For most people, the benefits of patella stabilisation surgery are long-lasting. The success of the surgery depends on several factors, including the type of procedure you have, the severity of your instability, and how well you follow recovery instructions and physiotherapy exercises.

What are the risks of patella stabilisation surgery?

Most people make a full recovery following patella stabilisation surgery, but like any surgery, it carries risks. Your consultant (surgeon) will talk you through these risks, answer any questions and help you feel more confident going into surgery.

Possible side effects of patella stabilisation surgery:

  • Pain: You will experience some pain and discomfort after your surgery, but this can be managed with pain medication.
  • Swelling: Your knee will be swollen after surgery, but this should gradually go down over the first few weeks.
  • Stiffness: Your knee may feel stiff after surgery, but this should improve with physiotherapy.
  • Numbness: You may have some numbness around your scars, but this usually improves over time.
  • Patella fracture: Sometimes, when drilling holes through your patella, this can make it weaker and at risk of a fracture (break).

Specific complications of patella stabilisation surgery:

  • Infection of the surgical site (wound): Let your consultant or healthcare team know any concerns about infection at the earliest opportunity. Seek their guidance first before going to your GP.
  • Blood clots (Deep vein Thrombosis DVT): A risk associated with any surgery.
  • Nerve damage: Injury to the nerves around your knee, leading to weakness, numbness or pain.
  • Blood vessel damage: There is a very small risk of damage to blood vessels around your knee, leading to loss of circulation to your leg and foot.
  • Continued instability/dislocation despite surgery: In a small number of cases, the kneecap may continue to be unstable after surgery.
  • Fracture: If you have a tibial tubercle osteotomy, there is a small risk of the bone not healing properly.

Alternatives to patella stabilisation surgery

Some non-surgical alternatives may help to manage patella instability, including:

  • Physiotherapy: A physiotherapist can teach you exercises to strengthen the muscles that support your kneecap, which can help to improve its stability. Explore our physiotherapy services at Nuffield Health.
  • Bracing: Wearing a knee brace can help to support your kneecap and prevent it from dislocating.
  • Activity modification: You may be advised to avoid activities that put a lot of stress on your knees, such as high-impact sports.

If these treatments do not work or if you have had multiple dislocations, surgery may be the best option to provide long-term stability to your knee.

How much does patella (kneecap) stabilisation surgery cost?

For pricing information, please get in touch with your local hospital.

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