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I am really pissed (am I allowed to say that on-line?). The surgeon keeps saying I had a "successful" patellar realignment surgery because the knee no longer dislocates. But it still feels like it's going to pop off sometimes and I can't play sports at the level I want to because it does hurt and I never know if it's going to give out from underneath me. Does this happen to other people or is it just me?

You are definitely not alone. According to a recent study, athletes who have stabilization surgery for repeated dislocations of the patella (knee cap) have a 93 per cent success rate following the procedure. "Success" was measured by the surgeon as less pain and improved function. They came to these conclusions by using patient surveys like the International Knee Documentation Committee (IKDC) or the Lysholm score. These tools are used to measure and compare before and after pain, function, and activity. Yet when surveyed, these same patients reported a much lower subjective (opinion) level of satisfaction. The study presented here confirms findings from other studies: patients do not always view their surgical results as successful. But at the same time, they do not return to the surgeon and report ongoing symptoms or problems. When knee assessment tools like the International Knee Documentation Committee (IKDC) or the Lysholm score are used to measure outcomes, the results look good on paper but do not always provide an accurate view of the patient's response. This isn't the first study to show a "disconnect" between surgical success and patient's perception of the results. More research is needed to understand all the reasons for less than optimal outcomes reported following patellar realignment surgery. In the meantime, it might be helpful for your surgeon if you put your thoughts and observations about your own outcomes down on paper. Sometimes seeing it in black and white helps bring home the message you are trying to get across.

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