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Dear Doctor

July 2020

Question:

My child is having sharp lateral knee pain 5 years post MPFL reconstruction with tibial tubercle osteotomy. It hurts her when she is doing a squat, going up stairs and curbs, etc. is this normal or can it be due to arthritic changes? 

- Maryland (Parent)

Answer:

I would guess from your note that your daughter is a teenager and that she had recurrent episodes of patellar (kneecap) dislocations that led to her MPFL (medial patellofemoral ligament) reconstruction and realignment of the extension mechanism with the tibial tubercle osteotomy.  Pain at the front of the knee is common even without the surgery she had. But it is also possible she has tightness in the tissues around the kneecap or a cartilage injury in the knee from when she was dislocating her kneecap, which could cause some arthritis. I would check in with an orthopedic surgeon for an exam and radiographs. Physical therapy to strengthen the muscle around the knee and ibuprofen or naprosyn would probably help. If it doesn’t, if the doctor’s exam is concerning, or if she has symptoms like knee locking, advanced imaging like an MRI might be indicated. 
Good luck!

- Maryland (Parent)