If dislocations become common, or there is associated swelling and cartilage damage in the joint, surgery may be indicated. Patellar realignment includes lengthening the tight ligaments and tightening the overstretched ligaments that surround the kneecap. If a more aggressive approach is needed, moving the patellar tendon medially will help the kneecap to track in a straight line. The extent of the surgical procedure is determined by the surgeon during the procedure. It is necessary to be aggressive enough to avoid future dislocations, but conservative enough to minimize your recovery.
Recovery takes 1 to 6 months depending on the extent of articular cartilage damage, and the repair needed. Full recovery cannot be expected until full muscle strength is obtained.
Surgery is very successful at improving patellar track and stabilization. The degree of underlying cartilage damage dictates the amount of pain relief.