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Book AppointmentMPFL (Medial Patellofemoral Ligament) Repair
There is a myriad of surgeries used to treat patella instability which include Medial patellofemoral ligament (MPFL) reconstruction, Tibial Tuberosity Transfer, Trochleoplasty and derotation osteotomy. All these are aimed at addressing instability of the patella (kneecap).
This MPFL ligament plays a crucial role in preventing the patella from dislocating outwards during knee movements. Sometimes, however kneecap dislocations happen due to hyperlaxity or abnormal lower limb bone shapes. All these factors must be carefully studied to determine which procedure would have the more effective outcome for the patient to restore stability and function to the knee joint.
Pre-Procedure Preparation
Before undergoing MPFL repair, patients undergo a thorough evaluation, including a physical examination and review of medical history. Imaging tests such as X-rays, MRI , and CT Scans are conducted to assess the extent of ligament damage, study the lower limb bone morphology and plan the surgical approach. Pre-operative instructions are provided, which may include fasting before surgery, adjusting medications, and arranging transportation to and from the hospital or surgical centre.
The Procedure
MPFL repair surgery begins with administering anaesthesia to ensure patient comfort. The surgeon typically uses arthroscopy, a minimally invasive technique, to access the knee joint. Small incisions are made to insert an arthroscope and surgical instruments. The surgeon identifies the torn or stretched MPFL and evaluates its condition. The ligament is reconstructed using a autograft or synthetic to stabilise the knee cap in the correct position and tension. In the case of abnormal bone morphology the surgeon may use procedures known as osteotomies to reorient the bony profile of the patient to promote better tracking of the knee cap. In special cases a repair of the MPFL may be performed, depending on the injury and patients age and requirement.
Post-Procedure Care
After surgery, the patient is monitored in a recovery room as anaesthesia wears off. Pain and swelling are managed with medications and ice packs. Patients receive detailed instructions on wound care, medications, and activity restrictions to promote healing and prevent complications. Physical therapy is initiated early to regain knee range of motion and strengthen the muscles around the knee joint. Gradual progression in physical activities is guided by the surgeon and physiotherapist.
Recovery Timeline
Recovery from surgery varies based on the extent of ligament damage, the type of surgery and the patient's response to surgery. Initial recovery typically involves reducing swelling and restoring knee mobility, which can take several weeks. Physical therapy focuses on strengthening the quadriceps and improving knee stability, with a gradual return to normal activities expected over several months. Full recovery to resume sports and high-impact activities may take 6-12 months, with regular follow-up appointments scheduled to monitor progress and adjust rehabilitation goals.
Conclusion
Surgeries for patella instability are effective and restore knee function. Successful outcomes depend on careful pre-operative planning, precise surgical technique, and diligent post-operative rehabilitation. Patients play a critical role in their recovery by following medical advice, participating actively in physical therapy, and communicating openly with their healthcare team. By adhering to the recovery plan, patients can achieve optimal results and regain confidence in their knee's stability and mobility.