Rehabilitation after patellar stabilisation: kneecap exercises, sport and recurrence

The NHS says a dislocated kneecap often moves back into place by itself, and that a doctor may have to move it back after strong pain relief if it does not. Surgery may be needed if the knee is significantly damaged or the kneecap dislocates more than once. Procedures to stabilise the patella take different forms, depending on why it keeps slipping, and are covered in the site's guide to the operations themselves.

Whether or not you have surgery, rehabilitation is the same in purpose: to give the knee strength and control so that the kneecap tracks properly and is less likely to slip again. After surgery the order and timing of exercises will follow your surgeon's protocol.

The NHS says that your doctor or a physiotherapist will show you knee exercises that you should do regularly to help speed up recovery. The key word is regularly. Stability around the kneecap depends on muscle strength, particularly of the thigh and hip, so the programme works through repetition over weeks and months rather than in occasional sessions.

Typical programmes begin with regaining movement and activating the thigh muscle, then build to balance and strength work, and later to controlled functional tasks. The precise exercises and the order differ between people and between operations, so use the sheet you are given.

The NHS says many people can start walking again as soon as they are treated, that crutches may be provided if walking hurts, and that a knee support, such as a brace or sleeve, may be worn during healing. After surgery these decisions are likely to be more specific: your surgeon may limit bending or weight-bearing for a period, and the discharge instructions set the rules.

• Ask whether you should wear a brace, and when you can take it off.

• Ask how far the knee may be bent at first.

• Ask whether you can put your full weight on the leg.

• Ask what to do if the knee feels as if it is slipping.

The NHS says it can take several months to fully recover from a dislocated kneecap. After stabilisation surgery the surgeon's protocol will usually run for a similar or longer period. No official page retrieved gives a single timetable that applies to every operation, and this guide does not give one.

For planning, assume that the knee will feel better well before it is fully strong. Many people stop doing exercises when the knee feels normal, which is the point at which the muscles are still catching up. Continuing the programme as advised is the best protection against another dislocation.

The NHS says not to play sport until the knee has fully recovered its usual strength, and that your doctor or physiotherapist can advise. It does not give a number of weeks or months. Sports that involve twisting, jumping or direct contact are the ones most likely to put the kneecap at risk, so your team may allow straight-line activities first.

Ask what tests they use to judge strength and control, and whether a brace is recommended for sport. If you play in a team, share your timetable with your coach so that expectations are realistic.

The NHS meniscus page lists signs of a serious knee problem that apply to any significantly injured knee. A knee that has moved out of place, changed shape or is pointing at an odd angle needs A&E, as does tingling or numbness in the knee, leg or toes. Very bad pain, being unable to bear weight, hot or swollen skin or a fever need urgent assessment.

After surgery, also follow your discharge advice about the wound. A new dislocation or a sudden sensation of the kneecap slipping should be reported to your surgical team promptly, even if the kneecap went back in by itself.

The NHS links surgery to repeated dislocation. The aim of rehabilitation after stabilisation is therefore to hold the gains from the operation while the knee strengthens. Guarding against recurrence is also why teams are cautious about twisting sport until strength is restored.