Medial Patellofemoral Ligament (MPFL) Reconstruction

Introduction:- 

The Medial Patellofemoral Ligament is a  ligaments made of group of bands of retinacular tissues that is an hour shaped ligament. This ligament play an important role and stabilization and support to the medial aspect of the Patella bone. Most importantly it acts during the early stages of knee flexion, it is the critical component in patellar tracking and its stability that is within the trochlear groove.

Attachments:- 

This ligament is located in the second layer of the three soft tissue layer that is within the medial aspect of the knee. It originates from the shape that is running between the adductor tubercle, that is superior to superficial medial collateral ligament. There is a broad insertion of the MPFL onto the superomedial aspect of Patella that is (20-30mm). There is proximal insertion that extends to quadricep tendon and the distal insertion crosses deep to distal vastus medialis obliques which has average length of 56mm.

How the medial patellofemoral ligament gets injured?:- 


Any MPFL injury or tear can be a result of any underlying knee abnormalities or can be due to weakening of leg muscles. MPFL is the most commonly injured ligament during any high impact contact sporting including tackles and pushes. During any MPFL injury the patella bone dislocates and there are tears in the ligament on inside of the knee. These types of tears and injuries always occur when the knee joint is straight and is slightly bent and the kneecap is forced extremely out of the specific place.

Symptoms of torn MPFL:-

Mostly the MPFL tears are due to traumatic dislocations and some are because of unidentified injuries, certain symptoms of torn MPFL are-
  • Extreme pain in the kneecap.
  • Pain during any activity
  • Swelling over the knee joint
  • Instability of knee joint
  • Stiffness
  • Lock-in of knee joint for long time
  • Bone crepitus sound
MPFL reconstruction:- 

The MPFL reconstruction is a typical surgical procedure that is used in correcting MPFL tears or reoccuring kneecap dislocations.  There are several techniques which are involved in the reconstruction process, but the most common technique involves using a tissue graft to reconstruct the torn ligament that helps to hold the kneecap in the correct position and to make proper articulation with the femur bone.

Other procedures involve the reconstruction of MPFL in which there is a new MPFL is created that keeps the knee stabile and protect the joint from any other further additional damage.     

Patient with MPFL tears generally go through an assessment that basically start with the physical condition and past medical history, basic investigation and MRI is performed to understand the condition of the ligament. MPFL reconstruction has excellent results and also is a way better technique with the low rate of complications, this is a safe procedure with very rare or no risk factors. 

Certain techniques that are used in reconstruction are-
  • Arthroscopic surgery - that's a minimal invasion surgery in which the damaged part or the torn part is being cleaned and replaced, this is the best available option as there are no chances of infection, Along with this it's done using light invasions which heels faster.
  • Medial imbrication - it's a procedure in which the MPFL is being tightened that procedure is called the tucking process.
  • Lateral release- this procedure generally involves loosening of the outer part of the patellofemoral ligament that helps in better recovery 

Recovering after Medial Patellofemoral Ligament (MPFL) Reconstruction:-

As a reconstructive surgery it's a complex procedure that needs time to heal, post surgery the knee will be immobilized and complete bed rest will be suggested as to avoid further progressions and complications.

The average healing time after this procedure is 2 to 3 months , the earliest healing phase include NSAIDs for the next 2 months, the patient is advised to take rest up to 1 month post surgery as this can affect the healing process which can lead to recurrent injuries, light activities are being prescribed after a certain time it can help to enhance the joint mobility and better contraction. Light activities including supportive walking, Range of motion enhancing exercise, stretching, passive muscle strengthening exercises are being prescribed.  To reduce pain and stiffness braces and physical agent modalities are being prescribed. 

Most of the times people return to normal routine and sport's after 4-5 months post MPFL Reconstruction surgery, the recovery also depends upon how the pateint is Caring and being introduced to precautionary measures. The recovery process often takes times in cases where there are reoccuring injuries or the patient is not aware of any internal manifestation in the joint.

Dr. Manish Maheshwari is one of the Best orthopedic surgeon and Knee specialists near me in Indore at affordable price. In cases of any torn ligaments, dislocations, fracture or reconstructive surgeries arthroscopy is the best option,In types of such cases always consult Dr. Manish Maheshwari at Indore Arthroscopy Center, Dr. Manish Maheshwari is ranked amongst one of the best orthopaedic surgeons in the central India. 

For appointment call us immediately on 9826252228 or visit our website - https://www.drmanishmaheshwari.com/



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