What is the timing of surgical treatment for recurrent and habitual patellar dislocation

Recurrent patellar dislocation: If the patella is dislocated more than twice, affecting normal life and sports, surgery is recommended. Surgery can not only stabilize the patella and reduce the recurrence of patellar dislocation, but also reduce the damage to the patellar cartilage caused by the dislocation and prevent the occurrence of osteoarthrosis of the patellofemoral joint. If the patellar dislocation recurrence interval is long, even once or twice a few years, and daily life is not affected, conservative treatment can also be considered, strengthening quadriceps strength exercises and avoiding movements that are likely to cause patellar dislocation as much as possible. Commonly used surgical methods include medial patellofemoral ligament reconstruction, medial support band tightening, tibial tuberosity displacement and lateral support band release, and the appropriate surgical procedure needs to be selected based on the patient’s age, mobility and imaging assessment.  Habitual patellar dislocation: In some patients, the patella is dislocated laterally whenever the knee is flexed to a certain degree, called habitual dislocation. In severe cases, the patella is dislocated regardless of knee extension or flexion, which is called persistent dislocation. The patient’s quadriceps muscle is obviously atrophied, and the lower limbs are weak and weak, and it is even difficult to walk. The contracture of the lateral head of the quadriceps and the iliotibial bundle, and the shortening of the knee extensor device make treatment very difficult, if not inoperable. Therefore, once a habitual dislocation is detected it should be operated as early as possible, and early surgery is the only way to restore the patient’s normal life and athletic ability.