A 15-year-old boy presented to the clinic having had a dislocation of his left patella just over 2 months ago. It had been knocked against a coffee table. A paramedic attended and relocated the patella. He did not seek further medical attention. Three days later, he twisted his leg in bed and his kneecap redislocated. He therefore attended the Emergency Department where it was relocated, and he was referred to the Fracture Clinic.

Fit and well.

His father stated when he was his son’s age, he also had problems with his kneecaps and a cousin has also had problems with his knees, although they were not entirely clear what this is. The patient stated that he was double jointed with a Beighton’s score 7 out of 9.

None

Bilaterally he had normal hip version and external tibial torsion of 20^°. His hips felt stiff. His knees were in varus with an intercondylar distance of 2 cm. His left leg was short 2 cm shorter than his right. He had no effusion. The VMO was absent on the left and his quadriceps power was MRC grade 4. His patellar apprehension was ++; his mediolateral glide was +++ compared to ++ on the right. He had J-shaped patellar tracking. His left knee was still tender along line of the MPFL. He had a full range of knee motion with recurvatum bilaterally of 10^°. His tibiofemoral joint was normal.

He had intensive physiotherapy on both his knee and had not dislocated since nor experienced any instability symptoms. He had been weaned off his orthosis. He was pleased with his progress but felt he could do better. He had not returned to sports. His Kujala score was 90.