Kneecap removal, or patellectomy, is the partial or total surgical removal of the patella, commonly called the kneecap.
Kneecap removal is performed under three circumstances:
A person of any age can break a kneecap in an accident. When the bone is shattered beyond repair, the kneecap has to be removed. No prosthesis or artificial replacement part is put in its place.
Dislocation of the kneecap is most common in young girls between the ages of 10–14. Initially, the kneecap will pop back into place of its own accord, but pain may continue. If dislocation occurs too often, or the kneecap does not go back into place correctly, the patella may rub the other bones in the knee, causing an arthritis-like condition. Some people are also born with birth defects that cause the kneecap to dislocate frequently.
Degenerative arthritis of the kneecap, also called patellar arthritis or chondromalacia patellae, can cause so much pain that it becomes necessary to remove the kneecap. As techniques of joint replacement have improved, arthritis in the knee is more frequently treated with total knee replacement .
People who have had their kneecap removed for degenerative arthritis and then later require a total knee replacement are more likely to have problems with the stability of their artificial knee than those who only have total knee replacement. This occurs because the realigned muscles and tendons provide less support once the kneecap is removed.
General anesthesia is typically used for kneecap removal surgery, though in some cases a spinal or epidural anesthetic is used. The surgeon makes a linear incision over the front of the kneecap. The damaged kneecap is examined. If a part or the entire kneecap is so severely damaged that it cannot be repaired, it may be partially removed (partial patellectomy) or totally removed (full patellectomy). If kneecap removal is total, the muscles and tendons attached to the kneecap are cut and the kneecap is removed. However, the quadriceps tendon above the kneecap, the patellar tendon below, and the other soft tissues around the kneecap are preserved so that the patient may still be able to extend the knee after surgery. Next, the muscles are sewn together, and the skin is closed with sutures or clips that stay in place for about two weeks.
Prior to surgery, x rays and other diagnostic tests are done on the knee to determine if removing the kneecap is the appropriate treatment. Preoperative blood and urine tests are also done.
Patients are asked not to eat or drink anything after midnight on the night before surgery. On the day of surgery, patients are directed to the hospital or clinic holding area where the final preparations are made. The knee area is usually shaved and the patient is asked to change into a hospital gown and to remove all jewelry, watches, dentures, and glasses.
Pain medication may be prescribed for a few days. The patient will initially need to use a cane or crutches to walk. Physical therapy exercises to strengthen the knee should start as soon as tolerated after surgery. Driving should be avoided for several weeks. Full recovery can take months.
Risks involved with kneecap removal are similar to those associated with any surgical procedure, mainly allergic reaction to anesthesia, excessive bleeding, and infection.
Kneecap removal is very delicate surgery because the kneecap is part of the extensor mechanism of the leg, meaning the muscles and ligaments, the patella, the quadriceps tendon, and the patellar tendon; which all allow the knee to extend and remain stable when extended. When the kneecap is removed, the extensor assembly becomes more lax, and it may be impossible to ever regain full extension.
People who undergo kneecap removal because of a broken bone or repeated dislocations have the best chance for complete recovery. Those who have this operation because of arthritis may have less successful results, and later need a total knee replacement.
Harner, C. D., K. G. Vince, and F. H. Fu, eds. Techniques in Knee Surgery. Philadelphia: Lippincott, Williams & Wilkins, 2001.
Winter Griffith, H., et al., eds. "Kneecap Removal." In The Complete Guide to Symptoms, Illness and Surgery, 3rd edition. New York: Berkeley Publishing, 1995.
Juni, P., et al. "Population Requirement for Primary Knee Replacement Surgery: A Cross-sectional Study." Rheumatology 42 (April 2003): 516–521.
Meijer, O. G., and Van Den Dikkenberg. "Levels of Analysis in Knee Surgery." Knee Surgery Sports Traumatology Arthroscopy 11 (January 2003): 53–54.
Petersen, W., C. Beske, V. Stein, and H. Laprell. "Arthroscopical Removal of a Projectile from the Intra-articular Cavity of the Knee Joint." Archives of Orthopaedic Trauma Surgery 122 (May 2002): 235–236.
The American Academy of Orthopaedic Surgeons. 6300 North River Road, Rosemont, IL 60018-4262. (847) 823-7186, (800) 346-AAOS. http://www.aaos.org .
The American Association of Hip and Knee Surgeons (AAHKS). 704 Florence Drive, Park Ridge, IL 60068-2104. (847) 698-1200. http://hhtp://www.aahks.org .
"Patellectomy." The Knee Guru Page. http://www.kneeguru.co.uk/html/step_05_patella/step_05_patellectomy.html .
" Patellectomy or Partial Patellectomy." Pro Team Physicians. http://www.proteamphysicians.com/Patient/Treat/knee/kneefracture/patellectomy_procedure.asp .
Tish Davidson, AM
Monique Laberge, PhD
Kneecap removal surgery is usually performed in an outpatient setting and hospital stays, if any, are short, not exceeding more than a day. An orthopedic surgeon performs the surgery. Orthopedics is the medical specialty that focuses on the diagnosis, care, and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin.
Thanks so much.
I had my kneecap removed in 1970, due to continual dislocations (I'm now 61). I don't recommend it. Stabilizing the kneecap would have been preferable, so the physicians tell me. One problem is loss of strength when straightening the leg. You may have a different situation, however.
She had a tumor growing from her spine ( i believe l2-l4). She has now four 8inch rods supporting her mid spine. The problem was that they had to remove nerves in order to remove the tumor completly. Those nerves happen to control her right thigh (quad) muscle. In a seated position she has no muscle whatsoever, and you can clearly see the difference between the left and right, as the right looks like its sitting on bone.
Naturally, she must hyper extend her knee as she walks. Her knee has buckled numerous of times, fallen on it etc... Fast forward to today, it feels as though her kneecap has dropped from where it should be positioned. So its positioned low. I feel as though this will only become worse to the point where she cannot walk.
Also, because she is hyper extending always and the fact she has no thigh muscle, her good knee (left) is taking a beating just to compensate and support the weight of her right side. She is only 31 and the doctors say she has the knee of a 50 year old and will likely kneed surgery on that knee as well.
Should she remove her kneecap of the bad knee? Perhaps releaving some pressure the sagging knee cap is causing?
I am sorry for rambling. I am truly at a loss and feel so helpless as i cannot do anything for her. I feel so much worse when she cant play with our four year old cause shes incapable of so many things we take for granted.
If someone can advise me . Please please email me. Advise me. Docs arent much help, they hae 6 month wait period for appointments. gill_larry@hotmail.com
Thank you and god bless to those with severe knee problems as it breaks my heart everyday seeing how much pain it can be.
My mum had a car accident about 30 years ago and lost her left kneecap as a result. The surgery was sort of a miracle, went well and she lived without major issue. Recently though at 60 years of age (and a little bit too much time on the dance floor) she experiences a lot of pain in her knee. The pain has been practically constant for the last few weeks-couple of months. Only very strong pain killers help and seems that their effectiveness decreases with time.
Does anyone know what I could do to help her? She can't live on pain killers and a surgery is out of the question, as it'd be very risky. I think she's done rehabilitation before. She's not a diabetic nor doesn't have any major conditions. Does anyone know any other methods e.g. injections? Anything that's fairly healthy and non-invasive.
Thank you
Would greatly appreciate hearing from anyone who has experienced this and can offer suggestions and encouragement
So just wanted to check should she do the surgey again and get the knee cap fixed will it help in reducing the pain and will it be advisable to go for the surgery.
Rgds
Zubin
THE DOCTOR TRIED TO REPAIR THE KNEE CAP. I DEVEOPED A REALLY BAD INFECTION IN MY KNEE AND LEG. SO I HAD TO HAVE MY KNEE REPLACEMENT REMOVED AND HAD TO STAY IN BED FOR 6= WEEKS WITH IV. NOW THE DOCTOR WILL BE DOING SURGERY AGAIN RIGHT BEFORE
HOLIDAYS . HE WANTS TO REDO KNEE REPLACEMENT IF INFECTION GONE OR IF NOT PUT SPACER BACK IN FOR ANOTHER 6= WEEKS.I WONT HAVE A KNEE CAP WILL I BEABLE TO WALK WITHOUT USING A AID OF CANE OR WALKER, I UNDERSTAND I WILL NEED WALKER ECT. AT FIRST
I QUESS WHAT IAM ASKING WILL I ALWAYS NEED SOMETHING TO AID IN MY WALKING.
ALSO THEY WILL BE TAKING A MUSCLE FROM LOWER PART OF MY LEG TO CLOSE WITH AND HAVE TO USE SKIN GRAF.
I have so many questions, is 1/2 a knee cap going to look disfiguring? What can I reasonably expect life to be like after therapy?
Christine
Due to the hardware failing back in December 2011 and reconstruction in August 2011, it tore my patella completely up. Which made the patella to be removed. I am able to have full extension in my leg. The only problem now is being able to walk stairs normal. After 4 leg extensions sitting down, I get cramping and grinding. Side, front and back lungs very limited. My knee stops at a certain point.
I'm looking for a brace to help me? Looking for years. Anyone has advice would be gratefully appreciated. I can out walk most of my friends. Its the stairs and unstable grounds to walk on. Most of the pain is caused where the patella once was.
PLEASE HELP
ive has an xray and it shows no arthritus or damage. i also suffer lower back pains
could this be over compensation and alignment issues. My last physio said something about Bio-mechanics
has anybody else suffered with this and whats the treatment
I had an accident in 2007 & had to have several operation including a bone graft & finally a patellactomy. I have great difficulties in moving without a walking aid as my leg just buckles. I recently fell & injured the same leg & have extreme pain. I was a person without any complications before my accident. Due to the operations i have developed arthritis. Is this possible & why does this happen.Can anyone advise what i can do for pain. How can i gain strength on this leg
I find it difficult to still do stairs most of the time and my knee gives at anytime without notice. Even in flats?? I was thinking of purchasing an electronic muscle stimulator for the thigh?? Has anyone tired this before other than at physical therapy? I found physical therapy not really informed of this procedure..
It was important to my doctor that I had full leg extension after surgery. So if you have it now after casting then you should be fine :) Good luck in your recovery! I golf as well, its just the stabilizing and strengthening the front thigh muscle I have problems with..
Great questions, but no information
My question is, I'm having a full knee cap removal this October 2019 on my right knee. Wondered if anyone else has had both out and what the experience has been like? Tho I expect much better recovery on my right knee as all my muscles are really strong, tho been getting chronic patella femoral pain last few months.
Personally I think double amputation should be the better option as I can't see any quality of life during the later stages of life with no kneecaps.