At first I thought the study was the National Library of Medicine’s version of the popular spoof news service “The Onion”. Here was a study stating that if the knee cap hurts, you should just remove it surgically. After all, let’s not try to help the pain, that wastes a perfectly good scalpel! However, this research paper brings up an important dark side to surgery, the urge to remove something that hurts with no regard to the long-time bio mechanical consequences of removing that structure.
The patella (knee cap) is a critical bone that lives in the end of your quadriceps (thigh) muscles. It lives in a grove (trochlear groove) in the femur (thigh bone). It acts as a crucial fulcrum to improve the ability of the quadriceps muscle to extend the leg. In fact, without it, your ability to move the leg would never be anything approaching normal.
The study that surgically yanked knee caps was just published on 8 unfortunate patients. The concept was that since the knee cap had lost cartilage and had arthritis, removing it would reduce pain. The surgery did help pain, with patients who only had arthritis on the patella doing better than those who also had it in the trochlear groove.
The upshot? Yikes! Removing the patella (or any part of the musculoskeletal system for that matter) will have serious consequences. The bone provides additional front back stability, helping the ACL stabilize, so you can bet the ACL ligament will be overloaded. As discussed, the power in the thigh will be lost, not to mention position sense in the knee. In conclusion, there are no spare parts in the musculoskeletal system! While patients often don’t really know what’s being removed surgically, every bit of tissue that we take out has downstream bio mechanical consequences.