Patella instability causes a variety of problems ranging from mild shifting or clicking of the patella (kneecap) to frank patella dislocation, chronic disability, trouble with stairs, inability to run, giving way of the knee, complete collapse of the knee, chronic pain, and accelerated arthritis of the knee. Fortunately, many patients with patella instability respond to nonsurgical treatments such as bracing, taping, modification of activities, and physical therapy. The Sports Medicine Division of Yale Medicine Orthopaedics & Rehabilitation provides specialized care for adults and children with patella instability. While nonsurgical options are almost always the first-step recommendation, Yale Medicine’s Patella Instability Program offers the best possible current technology and expertise to enable patients to have a successful return to normal activities. To find out more about this program, please fill out a brief survey . The Patella Instability Program utilizes the highest quality advanced imaging, including magnetic resonance imaging (MRI) and computerized tomography (CT), for patient evaluation, in collaboration with Yale Medicine’s Department of Radiology & Biomedical Imaging. Our Orthopaedic specialists work with the Radiology departments and the Yale School of Engineering to offer a major initiative in three-dimensional (3-D) imaging and printing, such that a patient’s knee can, in certain complex situations, be printed into a 3-D model for detailed analysis and optimal surgical planning. 3-D analysis is particularly important for patients with trochlea dysplasia, a condition in which the femur’s groove for the patella is too shallow and deformed, worsening the patient’s symptoms of patella instability and recurrent dislocation of the patella. Yale Medicine Orthopaedics & Rehabilitation’s Division of Sports Medicine is actively researching the complexities of patellofemoral dysplasia in order to offer every patient the best possible outcome. Our program is also engaged in national and international education of orthopedic surgeons and other care providers about optimal treatment of patella instability patients. When surgery becomes necessary for patients with patella instability, Yale Medicine’s Orthopaedics and Rehabilitation Sports Medicine division offers extensive expertise and long experience. The goal is to minimize surgery whenever possible, but also to recognize when more definitive surgical treatment is necessary. Our surgeons offer over 50 years of cumulative experience with tibial tubercle transfer (TTO or AMZ) and medial stabilization (MPFL or MQTFL) surgery and can manage most patients with these procedures on an outpatient basis at the McGivney Surgery Center, and Greenwich Hospital. The facilities at the McGivney Advanced Surgery Center in New Haven and Greenwich Hospital allow our surgeons to provide state-of-the-art, cutting-edge surgical treatments in order to give patients the best potential f

We are committed to excellence in all areas of musculoskeletal care. Our physicians treat a variety of bone, joint, nerve, and muscle ailments across many orthopaedic specialties. Our physicians work in conjunction with primary care and specialty physicians to treat both common and complex musculoskeletal problems. We're here to help with all aspects of orthopedic care. Whether you are seeking treatment for a minor injury or a serious orthopedic concern, our skilled doctors are experienced in minimally invasive improvements, as well as procedures like joint reconstruction and replacement surgery to help you get moving again. Some of the more common conditions our specialists treat include: Spinal problems, including degenerative conditions, disk herniations, scoliosis, spinal stenosis, fractures, and tumors Shoulder problems, including rotator cuff disease, arthroscopic surgery, arthritis, joint replacement, fractures, and instability Elbow problems, including arthritis, fractures and dislocations, joint replacement, and instability Hand and wrist problems, including arthritis, fractures, arthroscopic surgery, joint replacement, and artery and nerve repairs Pelvis and hip problems, including arthritis, arthroscopic surgery, joint replacement, and fractures Knee problems, including ligament and meniscal tears, arthritis, arthroscopic surgery, joint replacement, and fractures Foot and ankle problems, including tendon and ligament repairs, fractures, arthritis, and joint replacement Pediatric problems, including congenital deformities and fractures Tumor and limb salvage surgery

ACL injuries are common. Approximately 175,000 ACL reconstructions are performed every year in the United States. An ACL tear renders the knee unstable and without surgery most people cannot return to cutting and pivoting types of activity and athletics. Furthermore, a knee with an ACL tear that is not operated on has a significantly higher risk of developing subsequent tearing of the meniscus (cartilage) and degenerative arthritis. For these reasons, most athletically active patients opt to have their ACL reconstructed. Advancements in video technology and surgical instrumentation have allowed ACL operations to be carried out using very minimally invasive techniques. However, not all surgeons are able to offer these cutting-edge techniques as they require the development of new and often more challenging surgical skills that have a steep learning curve and take time to master. Several of our Yale Sports Medicine surgeons are involved in the teaching of these techniques at courses offered throughout the U.S. To find out more about this program, please fill out a brief survey . The surgical faculty are all fellowship-trained and board-certified in Orthopaedic Surgery and the majority are sub-specialty board certified in Orthopaedic Sports Medicine. The team also includes a number of renowned musculoskeletal radiologists who we routinely consult and collaborate with on all aspects of imaging, including plain X-ray, CT scan, and high-resolution MRI. Our anesthesia colleagues are experts in the most up-to-date regional anesthesia techniques so that post-operative pain is kept to a minimum. Experienced and skilled physical therapists also play a critical role on our team. Utilizing the most current machinery and “return to sport” assessment tools, they help us determine when patients are ready to get back into the game. A team of orthopaedic physician assistants, skilled nurses, and athletic trainers round out our comprehensive and compassionate approach to care. ACL reconstructive surgery involves “replacing” the torn tissue with a tendon either from the patient’s body (called an autograft) or from a cadaver (called an allograft). Traditionally, the two most common autografts used in ACL reconstruction have been the bone-patellar tendon-bone graft and hamstring tendons autograft. Recently, the use of the central third of the quadriceps tendon (from the front of the knee) has become more popular, and surgeons in our program are now utilizing this graft on a routine basis for ACL reconstruction. The quadriceps tendon graft is robust and very strong and has a lower incidence of some of the more common complications seen with other graft sources such as anterior knee pain and numbness about the knee. While use of the quadriceps tendon still only represents approximately 11% of all ACL operations, our Sports Medicine division is on the vanguard of this movement as we strive to offer our patients what we feel is the best possible treatment for their cond