The patella or kneecap can become unstable and slip out or dislocate for a number of reasons.

If physiotherapy and other non-operative treatments have failed to resolve this problem, then surgical stabilisation can be helpful.

One of the commonest operations involves moving or transferring the tibial tubercle or moving the attachment of the patellar tendon on the shinbone. This is often referred to as a Fulkerson’s osteotomy.

The operation moves the bony attachment of the patella or kneecap tendon forwards and towards the inner aspect of the knee.

The procedure is performed under general anaesthetic and the new position of bony attachment is held with two screws.

In addition a keyhole procedure is performed to release the soft tissues on the side of the patella.

Post-operatively the knee is protected in a brace for at least 6 weeks while the new bony prominence heals within its new position.

Complications with the surgery include DVT or venous thrombosis, infection, failure of the bony fragments to heal, damage to nerves and blood vessels at the back of the knee and failure to fully control stability of the kneecap resulting in further episodes of instability.

In the majority of cases the operation is successful and uncomplicated.