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MPFL Reconstruction

Medial Patellofemoral Ligament (MPFL) & Patellar Instability

What is the MPFL?
The Medial Patellofemoral Ligament (MPFL) is a key stabilizer of the knee. It connects the inner side of the kneecap (patella) to the thigh bone (femur) and guides the patella along the trochlear groove during knee bending and straightening.

When functioning properly, the MPFL acts like a restraint, keeping the kneecap in place and preventing it from shifting outward.

How Does MPFL Injury Happen?
An MPFL tear usually occurs during kneecap dislocation or subluxation and may result from:

  • Traumatic injury during sports or a fall
  • Inherently loose ligaments (common in women and young girls)
  • Abnormal bone alignment or shape of the patellofemoral joint

During a dislocation, the patella may “jump” out of its track and snap back, stretching or tearing the MPFL. This typically causes:

  • Sudden pain and swelling

  • Feeling of instability or the kneecap “slipping out”

  • Risk of future dislocations

Why Treatment is Important
If left untreated, the MPFL may heal stretched or weakened, causing chronic patellar instability. Repeated dislocations can damage cartilage under the kneecap, increasing the risk of patellofemoral arthritis.

MPFL Reconstruction Surgery

What Is It?
MPFL reconstruction is a surgical procedure to restore kneecap stability by replacing the damaged ligament with a graft (from the patient or donor).

Indications:

  • Recurrent patellar dislocations

  • Failure of conservative treatments such as bracing and physiotherapy

MPFL reconstruction is an effective modern solution. Before 2006, treatment was limited to immobilization and rehabilitation, often with limited success in preventing further instability.

Post-Surgery Recovery

  • Weight-bearing is allowed immediately, but the leg is supported in a brace for about six weeks to keep the knee straight

  • Continuous Passive Motion (CPM) machines may be used at home to prevent stiffness

  • Formal physiotherapy begins around six weeks post-op, once quadriceps strength improves

  • Optional tools may include electrical stimulation for muscle strengthening and compression/cold therapy to reduce swelling

Return to Sports

  • Most patients resume athletic activities within 4 to 7 months

  • Recovery time varies depending on individual healing, pre-existing joint conditions, and adherence to rehabilitation

  • A personalized recovery plan is provided based on surgical outcome and patient needs