MPFL Reconstruction
MPFL Reconstruction
The Medial Patello- Femoral ligament (MPFL) is a part of the complex network of soft tissues that stabilize the knee. The MPFL is a ligament that stabilizes patella (kneecap) to the thigh bone (Femur) .This ligament is strong but has elasticity that holds the knee cap during the knee movements and prevents the kneecap from dislocating to the outside of the knee. Injury to the MPFL can occur when the patella dislocates or becomes subluxated (partially dislocated) due to a trauma experienced during any sport activity or an accident. Individuals having generalised ligamentous laxity and bony anatomical variations are more prone for MPFL tear with trivial trauma. People with these injuries are described as having patellar instability
Injury to the MPFL
In a healthy knee, the bones that make up the patellofemoral joint move smoothly against one another as the joint is flexed or extended. The patella glides in the trochlea (groove) of the femur. The MPFL plays a vital role in keeping the patella on track (that is, in this groove) by acting like a leash that restrains the patella’s movement.
When a patellar dislocation occurs, soft tissues are damaged as the patella “jumps” the track and then comes forcibly back into place. Because the kneecap dislocates toward the outside of the leg, the ligament inside the knee (the MPFL) gets torn.
Left untreated, an injured MPFL can heal on its own. However, when left alone, the ligament heals in a loosened, lengthened position. This causes instability, which makes it easier for the patella to become dislocated again in the future. This, in turn, can cause damage to the cartilage in the knee. While the pain, swelling, and disability associated with a dislocated kneecap are problems in themselves, the greater concern is a subsequent injury to the cartilage that covers the bones’ ends where they meet in the knee joint. Once this cartilage is damaged, you are at a high risk of developing patellofemoral arthritis, a significantly more difficult condition to treat. For this reason, it is always advisable to get treatment that will prevent further dislocations of the knee.
The symptoms of an injured or torn MPFL may include :
Pain in the kneecap, especially when palpated or with activity
Swelling in the knee after any activity of the knee
Feeling of instability or of the knee “giving way”
Stiffness or pain after sitting for a long time
Feeling the kneecap slip, especially while turning
Treatment
Conservative management with braces and physiotherapy is the mainstay of management in primary patella dislocation.
Medial patella-femoral ligament (MPFL) reconstruction is the surgical procedure used to correct recurring kneecap dislocations. MPFL reconstruction uses a tissue graft to reconstruct the ligament and hold the kneecap in the correct position on the femur.