MPFL

MPFL (Medial Patellofemoral Ligament) Repair is a surgical procedure performed to repair or reconstruct the MPFL, a ligament that helps stabilize the kneecap (patella) by connecting it to the femur (thighbone). The MPFL plays a crucial role in keeping the patella in its proper position, particularly during knee movements. A tear or injury to the MPFL can lead to patellar instability, causing the kneecap to dislocate or subluxate (partially dislocate), resulting in pain, swelling, and difficulty with knee movements. MPFL repair restores the stability of the patella and improves function, helping to prevent recurrent dislocations and improve the knee's overall function.

The need for MPFL repair typically arises after a patellar dislocation or recurrent subluxations. Patellar dislocation usually occurs due to trauma, such as sports injuries or falls, but can also be caused by anatomical factors like malalignment of the knee joint, shallow femoral grooves, or an excessively loose ligament. Individuals who experience repeated patellar dislocations may develop chronic instability, leading to increased pain, difficulty walking, and loss of confidence in the knee's stability. In cases where conservative treatments like bracing, physical therapy, and anti-inflammatory medications fail, MPFL repair surgery may be recommended to restore patellar stability and function.

MPFL repair is a commonly recommended treatment for patellar instability due to ligament injury. Non-surgical treatments, such as rest, ice, physical therapy, and bracing, are often attempted initially to strengthen the muscles around the knee and improve stability. When these methods fail to provide relief, MPFL repair or reconstruction becomes necessary. During the procedure, the surgeon reattaches the torn or damaged MPFL to the femur using sutures or a graft. In cases where the ligament is too damaged to be repaired, a reconstruction may be performed using tissue from the patient's own body (autograft) or a donor (allograft). The goal of the surgery is to restore proper alignment of the patella and prevent future dislocations.

Before undergoing MPFL repair, patients typically undergo a thorough evaluation that includes imaging studies such as X-rays or MRIs to assess the extent of the patellar instability and the condition of the MPFL. The surgeon will discuss the procedure, anesthesia options, and expected recovery time. Preoperative physical therapy may be recommended to strengthen the muscles around the knee and improve its stability. In some cases, the patient may need to stop taking certain medications, such as blood thinners, and follow specific instructions regarding fasting before surgery. Emotional preparation is also important, as MPFL repair requires a commitment to rehabilitation and recovery for optimal results.

MPFL repair is typically performed using an arthroscopic approach, which is minimally invasive. The patient is placed under general or regional anesthesia to ensure comfort throughout the procedure. The surgeon makes small incisions around the knee and inserts a camera (arthroscope) to visualize the damaged ligament. The torn MPFL is either repaired by suturing the ligament back to its original attachment site on the femur or reconstructed using a graft if the ligament is too damaged. The graft is secured using screws or other fixation devices. The procedure usually takes about 1-2 hours, depending on the severity of the damage and whether reconstruction is needed. The surgeon will ensure proper alignment and tension before closing the incisions.

After MPFL repair surgery, patients are monitored in the recovery room for any immediate complications, such as bleeding, infection, or blood clots. Pain management is provided through medications, and ice therapy is applied to reduce swelling. The knee may be braced or immobilized for a short period to ensure proper healing. Patients are usually advised to avoid putting weight on the knee and to use crutches for the first few days to reduce strain on the repaired ligament. Physical therapy begins within the first week after surgery, focusing on gentle range of motion exercises to prevent stiffness and promote circulation. Most patients can return to light activity within 4-6 weeks, but more strenuous activities or sports are typically avoided for several months.

Rehabilitation is essential for achieving optimal results after MPFL repair. Physical therapy typically begins within days of surgery and focuses on regaining range of motion, reducing swelling, and strengthening the quadriceps and hamstring muscles. As the knee heals, patients gradually progress to more intensive exercises to improve strength, stability, and mobility. Full recovery from MPFL repair may take 4-6 months, with return to sports or high-impact activities usually occurring between 6-9 months, depending on the individual and the extent of the injury. Long-term care involves maintaining knee strength through regular exercise and avoiding activities that may place excessive stress on the patella. Periodic follow-ups with the surgeon are necessary to ensure the ligament has healed properly and the knee remains stable.