Dr Sean Leo · Orthopaedic Surgeon, Singapore
Unstable kneecap in Singapore: assessment and treatment options
A kneecap dislocation happens when the kneecap comes fully out of its groove. Two kinds of correction treat kneecap instability.
Call Orthosports@NovenaCall Orthosports@Connexion
Dr Sean Leo’s qualifications are MBBS, MRCS (Ed), MMed (Ortho) and FRCSEd (Ortho).
Orthosports@Novena, Mount Elizabeth Novena Specialist Centre · Orthosports@Connexion, Connexion, Farrer Park Hospital
Who this page is for
Is this you?
Is this you?
- Many people describe the knee giving way.
- Pain and swelling around the kneecap can follow an episode.
- After a first dislocation, some people are left with an ongoing sense that the kneecap may give way again.
The first visit
Your first consultation
Deciding together
Your first consultation
Early assessment is sensible after a kneecap dislocation, so the knee can be examined while the picture is clearest. Assessment combines the story of what happened, an examination of the knee, and imaging. The story and the examination come first. The examination looks at how the kneecap moves, and whether pushing it outward reproduces the feeling of instability.
Imaging then shows the anatomy, and each type does a different job. An X-ray shows the bones, including the height and groove shape of the kneecap, and can exclude a fracture or a loose fragment. CT or MRI can measure how the kneecap sits relative to the shin bone. MRI is the key test for the soft tissues and, importantly, for cartilage injury and loose fragments after a dislocation. Bring your MRI if you have one. No scan on its own decides treatment.
Being assessed is not a commitment to surgery.
Every plan weighs the same three things: the joint, you, and your goal.
- Structure: what the knee actually shows.
- Patient: who you are and what you can carry.
- Goal: what you want to return to.
These three questions — Structure, Patient and Goal — organise the consultation together. The plan matches all three; no single feature, including the scan, decides treatment on its own.
An assessment brings together the history, an examination where needed and any useful tests, and helps you and your clinician decide what to do next.
Options
Treatment options at a glance
Treatment options at a glance
For many people, the starting point is not surgery. Conservative care is a physiotherapy-led programme built around quadriceps and gluteal strengthening, restoring range of motion, and rebuilding gait and neuromuscular control. There is usually a short period of protection, followed by a graded return to activity as the knee settles and confidence returns.
This path suits a first-time dislocation with a low-risk profile and no significant loose fragment in the joint. Non-surgical care is not a promise that the kneecap will not dislocate again.
Not every first dislocation needs surgery. Surgery is generally considered when instability keeps causing problems despite a period of rehabilitation.
- MPFL reconstruction is the soft-tissue approach: it rebuilds the torn or stretched ligament when ligament laxity is the main problem and the bony alignment is adequate.
- Tibial tubercle osteotomy (kneecap realignment) is the bony approach: it repositions the kneecap’s attachment on the shin bone when the instability is driven by alignment.
They correct different problems. When soft-tissue and bony factors coexist, both are addressed together. The choice is made from your imaging and examination at assessment, not from symptoms alone.
Every operation carries risks, and it is important that you meet these clearly before deciding. As with any operation, there are the standard surgical risks of infection, wound problems and anaesthesia; your surgeon will discuss these with you directly. No operation can promise that a kneecap will never dislocate again.
The final decision follows your assessment and imaging. It is made with you, not by this page.
Meet Dr Sean Leo
Meet Dr Sean Leo
A consultant orthopaedic surgeon whose clinical focus is the knee, sports injuries and the lower limb.
- Dr Sean Leo is a consultant orthopaedic surgeon. OrthoKinetics is his professional brand; clinical services are provided through OrthoSports Orthopaedic & Sports Surgery at Mount Elizabeth Novena Specialist Centre and Connexion, Farrer Park Hospital.
- His clinical interests include sports injuries, including those in adolescent athletes; ligament reconstruction; realignment surgery; cartilage repair and joint-preservation approaches; knee replacement; and technology-assisted hip and knee surgery.
- The consistent aim is to return people to meaningful function and activity while avoiding unnecessary downtime.
- Qualifications: MBBS, MRCS (Ed), MMed (Ortho), FRCSEd (Ortho).
More detail: Meet Dr Sean Leo
- Training and career: Dr Leo trained in medicine at the National University of Singapore and served in the Singapore Armed Forces Medical Corps from 2000 to 2012, where his work included the care of soldiers in physically demanding roles. He completed postgraduate orthopaedic training in 2009 and a one-year clinical fellowship at Royal North Shore Hospital in Sydney, Australia, before joining Changi General Hospital as an orthopaedic consultant in 2012, where he later held the positions of Senior Consultant and Director of the Hip and Knee Service. With seniority, his educational contribution has evolved towards mentorship and support for junior doctors.
Costs and insurance
Cost, Medisave and insurance
Practicalities
Cost, Medisave and insurance
A cost estimate for surgery can be given only after a consultation and assessment, once a surgical plan has been developed. Each individual case is unique — the procedure performed, the implants used, the time taken and other factors all contribute to the overall estimate. Should you decide on surgical management, the clinic will provide you with this estimate, which is also used to help obtain pre-authorisation from insurance where applicable.
Medisave can generally be used toward eligible surgical procedures, but the amount that can be used, and whether a particular procedure is claimable, depends on the specific procedure code and your own circumstances. Insurance coverage likewise depends on your individual policy terms. This page does not promise any particular coverage outcome.
Benefits, pre-authorisation, letters of guarantee, panel rules and reimbursement depend on your individual policy and the insurer’s decision. Neither panel status nor co-management guarantees coverage, approval or cashless treatment. The clinic team can assist with claim paperwork, but cannot promise the outcome.
Because figures change and are specific to each case, the reliable way to get current numbers is to ask for a verified cost estimate through the clinic’s appointment or billing route, rather than relying on figures quoted on a public page. Ask for a current written estimate and check your own policy.
Insurance panels. Dr Sean Leo, Orthopaedic Surgeon, is on the specialist panels of Great Eastern (GE Panel), HSBC Life (HSBC Life Shield) and Singlife (Singlife Shield), and on the Prudential Panel. AXA Insurance Singapore became part of HSBC Life in 2023, and former AXA Shield plans are now HSBC Life Shield plans.
Corporate health plans. Dr Leo is on the panels of both Alliance Medinet and iXchange, which administer medical benefits for many company health plans. If your company plan uses either panel, you can see Dr Leo as a panel doctor.
If your company uses a different panel. Some company plans still let you see a doctor of your choice outside their panel, then claim reimbursement. This varies from plan to plan, as may the co-payment, so please check your benefits with your company’s HR department.
Panel arrangements change from time to time, so please confirm with your insurer or your company’s plan administrator before your appointment.
Dr Leo is on the panels shown. If your insurer is not listed, you may ask whether co-management with an Orthosports surgeon partner on that panel is clinically and administratively appropriate. Orthosports surgeon partners are collectively on the panels of all Shield plans.
Questions people often ask
Common kneecap questions
Common kneecap questions
Do I need surgery after a first-time kneecap dislocation?
Usually not straight away. A low-risk first dislocation is typically managed with non-operative care first.
What is the difference between MPFL reconstruction and kneecap realignment (TTO)?
MPFL reconstruction is a soft-tissue correction; a tibial tubercle osteotomy is a bony one. They are two sides of the same coin, and many knees need a little of each.
How do I choose between a bony and a soft-tissue correction?
You generally do not choose alone. Imaging and examination decide. The two are frequently combined, and the decision is made on your anatomy rather than one option being “better”.
What is a tibial tubercle osteotomy?
A tibial tubercle osteotomy (TTO) is a surgical cut that detaches the tibial tubercle — the bony bump on the shin where the patellar tendon attaches — repositions it, and fixes it back with screws. This changes the line of pull of the kneecap tendon to correct a bony alignment problem. It is a bone-cutting operation, not a keyhole procedure.
What graft is used?
Most commonly, your own hamstring tendon. Alternatives exist, and the evidence shows comparable outcomes between the main choices. Graft choice is a surgical decision.
Next step
Arrange a consultation
Appointments are arranged through the OrthoSports clinic team. Send your details below, or message or call the clinic.
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38 Irrawaddy Road, #10-41 Mount Elizabeth Novena Specialist Centre, Singapore 329563 Map for Orthosports@Novena (opens Google Maps)
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