MPFL Repair

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MPFL Repair

MPFL (Medial Patellofemoral Ligament) Repair is a surgical procedure performed to treat patellar instability or dislocations. The MPFL is a ligament on the inner side of the knee that helps stabilize the patella (kneecap) by keeping it aligned with the femoral groove. When this ligament is damaged due to trauma, overuse, or a congenital condition, it can result in recurrent patellar dislocations or instability, leading to pain, swelling, and difficulty with activities such as walking, climbing stairs, or participating in sports. MPFL repair or reconstruction aims to restore the function of this ligament and prevent further dislocations.

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When is MPFL Repair Recommended?

MPFL repair is typically recommended for individuals who experience frequent or recurrent dislocations of the patella, especially after non-surgical treatments have failed. It is commonly seen in young, active individuals or athletes involved in sports that require rapid changes in direction or jumping. Symptoms of patellar instability may include a feeling of the knee "giving way," pain around the patella, or a noticeable pop when the knee dislocates. Imaging techniques such as MRI and X-rays help assess the extent of the damage to the MPFL and determine whether surgery is necessary.

Preparing for MPFL Repair

Before undergoing MPFL repair, patients will undergo a thorough pre-operative evaluation. This includes diagnostic imaging to evaluate the condition of the knee joint and to rule out other injuries that could impact surgery. Prehabilitation exercises are often recommended to strengthen the muscles around the knee, particularly the quadriceps, to support the joint and reduce the risk of complications during recovery. Patients should also disclose any pre-existing medical conditions and medications to the surgical team, ensuring a personalized approach to care. Understanding the procedure and recovery expectations through pre-operative counseling can improve the overall outcome and provide clarity on rehabilitation goals.

The Surgical Procedure

MPFL repair is typically performed under general or regional anesthesia, and the surgery may last between 1-2 hours. The surgeon begins by making small incisions around the knee joint to access the MPFL. If the ligament is torn, the surgeon may repair it by reattaching the torn ligament to the femur using sutures or anchors. In some cases, if the ligament is severely damaged or stretched, a tendon graft may be used to reconstruct the MPFL. Once the ligament is repaired or reconstructed, the knee is tested for stability, and the surgeon ensures that the patella tracks properly within the femoral groove. The incision is then closed, and a sterile dressing is applied.

Recovery and Rehabilitation

The recovery process following MPFL repair is gradual, and patients typically use crutches and wear a knee brace to limit movement during the early healing phase. Pain management, including medications and ice, is used to manage discomfort and reduce swelling. Physical therapy is crucial to restore strength, flexibility, and knee function. Early rehabilitation focuses on regaining the range of motion and minimizing stiffness, while later stages involve strengthening exercises, particularly for the quadriceps and hamstrings. Most patients can return to light activities within 3-4 months, with full recovery and return to sports typically occurring within 6-9 months, depending on the healing process and adherence to rehabilitation protocols.

Benefits and Risks

MPFL repair offers significant benefits, including restoring knee stability and preventing recurrent patellar dislocations, which can be debilitating for active individuals. The procedure helps alleviate pain, reduce swelling, and improve the overall function of the knee, allowing patients to return to daily activities and sports. However, as with any surgery, there are risks involved, such as infection, blood clots, stiffness, or graft failure. A careful surgical approach, along with proper post-operative care and rehabilitation, can minimize these risks and contribute to a successful recovery. Most patients experience a significant improvement in knee function and are able to return to their previous level of activity.