Ace Physiotherapy and Sports in Singapore
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Patellectomy
A patellectomy is a surgical procedure in which the patella (kneecap) is removed. This can be performed as a complete patellectomy, where the entire patella is removed, or as a partial patellectomy, where only a portion of the patella is removed.
The patella, or kneecap, is a small, floating sesamoid bone located at the front of the knee. It is one of three bones that form the knee joint, along with the tibia (shin bone) and femur (thigh bone). The patella is embedded within the quadriceps tendon, which connects the quadriceps muscle of the thigh to the tibia below the knee joint. Acting as a pulley for the quadriceps, the patella helps generate greater force during knee movements.
A patellectomy is a surgical procedure to remove the patella, or kneecap. It can be either a complete patellectomy, where the entire patella is removed, or a partial patellectomy, where only a portion of the kneecap is excised. The patella is a small, floating sesamoid bone located at the front of the knee, embedded within the quadriceps tendon. It connects the quadriceps muscle of the thigh to the tibia (shin bone) below the knee joint and acts as a pulley, helping generate more power during knee movements. A patellectomy may be required for several reasons, including severe osteoarthritis of the knee, persistent anterior knee pain, or a comminuted (shattered) fracture of the patella.
During a patellectomy, an incision is made through the quadriceps tendon, and the patella is carefully freed and removed. The patella tendon remains intact and partially functional; however, removing the patella can lead to a number of functional issues, including:
- Reduced ability to fully straighten the knee (extension weakness)
- Decreased strength in the quadriceps muscle
- Altered biomechanics of the knee joint, affecting walking and running
- Increased stress on surrounding joints and soft tissues
- Potential for long-term pain or instability in the knee
Patellectomy is usually considered a last-resort procedure, performed only when all alternative treatment options are not viable. Removal of the patella can result in a permanently weakened ability to straighten the leg (extension weakness) and may compromise quadriceps function. Additionally, the absence of the patella can create challenges if a total knee replacement is required in the future, as the normal anatomy and biomechanics of the knee are altered.
Physiotherapy before patellectomy
acephysiosports.com recommends physiotherapy prior to your patellectomy to better prepare your knee for surgery and strengthen the muscles around your knee for essential support. Physiotherapy with acephysiosports.com before your surgery will focus on strengthening your quadriceps muscle as much as possible to reduce the likelihood of decreased range of movement once your patella has been removed. Your physiotherapy will also include strengthening the muscles in your hip, ankle, and opposite leg to ensure your knee has as much support as possible after your surgery.
Symptoms after patellectomy
Once your patella has been removed, you will experience instability in your knee joint along with pain and swelling. Stiffness and a significant reduction in range of movement in your knee are common, and you may be unable to fully straighten your leg. You will be provided with crutches for up to 2 months after your surgery and will also be required to use a knee brace or immobiliser during this time to protect and support your knee. Driving will not be possible until you have regained full, painless range of movement in your knee.
Physiotherapy after patellectomy
A comprehensive physiotherapy programme is crucial after undergoing a patellectomy to ensure the success of the surgery, restore stability, and regain as much function as possible in your knee. Physiotherapy will focus on reducing pain and swelling, improving range of movement, strengthening the quadriceps and surrounding muscles, and retraining gait and balance. Consistent rehabilitation will help maximise recovery, prevent further complications, and allow you to return to everyday activities safely.
Early stage (0-4 weeks)
In the initial weeks following your patellectomy, a physiotherapy programme with acephysiosports.com will focus on maintaining mobility, reducing pain and swelling, improving stability, increasing range of movement, and strengthening the muscles in and around your knee. At this stage, you will be non-weight bearing, using crutches, and wearing a knee immobiliser to protect your knee. Your physiotherapy will include:
- Gentle range of motion exercises for the knee to prevent stiffness
- Isometric quadriceps exercises to maintain muscle activation without stressing the joint
- Hip and ankle strengthening exercises to support the injured leg
- Controlled movement of the uninjured leg to maintain overall lower limb function
- Techniques to reduce swelling such as elevation, ice, and gentle massage
Middle stages (4-8 weeks)
After the first month of physiotherapy following your patellectomy, your programme with acephysiosports.com will focus on continuing the strengthening and flexibility exercises introduced in previous weeks for your quadriceps, hamstrings, and calf muscles. The programme will also aim to control any pain, stiffness, and swelling, while strengthening your hip, ankle, and opposite leg to provide continued support. At this stage, you will begin partially weight bearing and continue using a knee brace. Exercises will now involve active (self-performed) range of movement. acephysiosports.com also recommends incorporating hydrotherapy to aid recovery and improve mobility.
Later stages (8-12 weeks)
In the later stages of your recovery, your physiotherapy programme with acephysiosports.com will focus on progressing to full weight bearing while incorporating functional exercises tailored to your hobbies, sport, or everyday activities. The programme will continue to emphasise stretching and strengthening of the muscles around your knee, hip, ankle, and opposite leg. Additionally, it will introduce exercises aimed at improving your cardiovascular fitness and overall endurance. Your physiotherapy will include:
- Full weight-bearing exercises to restore normal gait and mobility
- Functional exercises specific to daily activities, hobbies, or sport
- Continued strengthening of quadriceps, hamstrings, calves, hip, and ankle muscles
- Stretching and flexibility exercises for all lower limb muscles
- Cardiovascular fitness exercises to improve endurance and overall fitness
- Proprioception and balance training to enhance stability and prevent future injury
Summary
A patellectomy is the surgical removal of your patella (kneecap). This procedure is typically performed to relieve symptoms caused by severe arthritis in the knee, debilitating anterior knee pain, or a shattered patella resulting from trauma. After your patella is removed, you may experience considerable knee instability, reduced muscle strength, limited range of movement, and diminished muscle control, leaving your knee joint less protected. It is essential to participate in a comprehensive physiotherapy programme with acephysiosports.com to restore stability, regain full or near-full function in your knee, and return to your everyday activities as soon as physically possible. Call acephysiosports.com now on +65 81535374 for more information or to book an appointment.
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