Kneecap removal
Kneecap removal, known medically as patellectomy, is a surgical procedure that involves the removal of the patella, or kneecap, typically performed in response to issues such as fractures, recurrent dislocations, or painful arthritic conditions affecting the kneecap. The surgery is indicated for individuals experiencing significant pain from conditions like retropatellar arthritis or chondromalacia patellae, where the undersurface of the kneecap becomes inflamed and roughened. The procedure begins with a thorough clinical examination and imaging studies, followed by anesthesia. During the surgery, an incision is made around the kneecap to access and remove it, after which the surrounding muscles and tissues are sutured back together.
Recovery from kneecap removal generally takes about six weeks and involves managing pain, reducing the risk of blood clots, and engaging in physical therapy to restore strength to the knee. While the procedure can alleviate pain and prevent the need for a total knee replacement, it can result in some loss of function and carries risks such as excessive bleeding and infection. Overall, kneecap removal can be a viable option for patients seeking relief from debilitating knee pain while considering their long-term mobility and health.
Subject Terms
Kneecap removal
Also known as: Patellectomy
Anatomy or system affected: Bones, joints, knees, legs, musculoskeletal system, tendons
Definition: The surgical removal of the kneecap
Indications and Procedures
The kneecap, or patella, is the triangular bone at the front of the knee. It is held in position by the lower end of the quadriceps muscle, which surrounds the patella and is attached to the upper part of the tibia by the patellar tendon. The role of the kneecap is to protect the knee.
Kneecap removalsurgery, or patellectomy, is performed as a result of fracture, frequent dislocation, or painful arthritis in the kneecap. Fracture is usually caused by a direct or sharp blow to the knee. Dislocation of the patella is often linked to a congenital abnormality, such as the underdevelopment of the lower end of the femur or excessive laxity of the ligaments that support the knee. Painful degenerative arthritic conditions, such as retropatellar arthritis and chondromalacia patellae, inflame and roughen the undersurface of the kneecap. Arthritic pain often worsens with the climbing of stairs or bending of the knee.
Before surgery begins, a clinical examination is conducted, including blood and urine studies and X-rays of both knees. The knee is thoroughly cleansed with antiseptic soap. Anesthesia is administered either by local injection or spinal injection, or inhalation and injection (general anesthesia).
Surgery begins with an incision made around the kneecap. The skin is pulled back, exposing the muscle-covered kneecap. Surrounding muscle and connecting tendons attached to the kneecap are cut, and the kneecap is carefully removed. The remaining muscle is then sewn back together with strong suture material. Surgery is completed with the closing of the skin with sutures or clips. Full recovery takes about six weeks.
Uses and Complications
Following surgery, a scar will form along the incision. As the incision heals, the scar will recede gradually. Pain from the incision can be alleviated with heating pads. The affected leg should be elevated with pillows. Frequent movement of the legs while resting in bed will decrease the likelihood of deep vein blood clots. General activity and returning to work are encouraged as soon as possible. Standing for prolonged periods of time, however, is not recommended during recovery. Following the approximate six-week recovery time, physical therapy is often used to restore strength to the knee.
Possible complications associated with kneecap removal include excessive bleeding and surgical wound infection. Additional complications can occur during recovery if general postoperative guidelines are not followed. Some loss of function can be expected. Kneecap removal surgery remains a viable option for patients to avoid a total knee replacement.
Bibliography
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