MPFL (Medial Patellofemoral Ligament) RECONSTRUCTION
The medial patellofemoral ligament (MPFL) is the primary ligament in the knee joint having elastic-like qualities, which helps stabilise the kneecap (patella) as the knee moves and prevents the joint from dislocation.The MPFL attaches the patella to the inner part of the knee. This ligament helps in stabilising the kneecap while movement of the knee joint, prevents it from moving or dislocating outward.
What is an MPFL ( medial patellofemoral ligament) tear?
The ligament is located in the center of the knee joint which runs from the thigh bone to the middle of the kneecap (Patella). Recurrent dislocations often occur on this ligament tear hence reconstruction of this ligament is required to stabilise the kneecap.
How does the MPFL injury occur?
The MPFL injury occurs mostly in the following cases::
- during a high impact sports event especially which includes pivoting or a tackle
- result of an underlying or existing knee abnormality or a weakened leg muscle.
- players of football, basketball, tennis or soccer are at risk
The patella tears the ligament on the inside of the knee when it dislocates leading to MPFL injury and surgery may be required to correct it.
This type of tear often occurs when the knee is straight or slightly bent leading to displace the kneecap from its original location.
What are the symptoms of an injured MPFL?
Common signs of an MPFL injury or MPFL tear may include:
- Pain in the kneecap on palpating or with any activity
- Swelling in the knee joint after activity
- Feeling of instability or feeling of slipping the knee cap
- Stiffness, locking or pain after prolonged sitting
How to diagnose a medial patellofemoral ligament injury?
To start with the patient’s history is taken by the Orthopedic surgeon to know the events that led up to the knee dislocation. It is followed by physical examination to look for the knee joint’s range of motion and site of pain.
Patients are recommended to get an MRI done to help the surgeon in assessing the knee and the health of the ligament thoroughly.
How to diagnose a medial patellofemoral ligament injury?
To start with the patient’s history is taken by the Orthopedic surgeon to know the events that led up to the knee dislocation. It is followed by physical examination to look for the knee joint’s range of motion and site of pain.
Patients are recommended to get an MRI done to help the surgeon in assessing the knee and the health of the ligament thoroughly.
What is MPFL reconstruction?
Medial patella-femoral ligament reconstruction is a surgical intervention done to correct recurring kneecap dislocation. A tissue graft is used in this procedure to reconstruct the ligament and keep the kneecap or patella in the correct position on the femur.
MPFL repairs differ from MPFL reconstruction as repair of MPFL is done in case of a tear in a very localized area at the time of knee dislocation in younger patients. The ligament is repaired with strong sutures or special surgical thread.
On the other hand,in a MPFL reconstruction a tissue graft is used to reconstruct the torn ligament completely. MPFL reconstruction is the preferred method of treatment by Dr.Divesh Gulati as it has better surgical outcomes than MPFL repair.
Recovery after MPFL reconstruction
Patients after MPFL reconstruction are put on a brace for 6 weeks to allow the ligament to heal. For the first two weeks after surgery, Knee joint motion is restricted to 90 degrees and then full motion is allowed.
Weight bearing is allowed after six weeks of surgery and patients are allowed to walk without the brace as soon as they are able to walk without a limp.
Physiotherapy and Rehabilitation programs can be initiated after 3 months of surgery to gain endurance and range of motion.
Most patients are expected to return to their respective sports and play 5-6 months after surgery.
