The MPFL (Medial Patello-Femoral Ligement) is the main ligament stabilising the kneecap. It helps to prevent dislocation of the kneecup. Whenever the patella experiences lateral movement, the MPFL is at risk of injury or tearing.
After the patella has dislocated once, it is common for the MPFL to become ruptured or stretched, resulting in reduced reliability to prevent further dislocations. In such cases, surgical reconstruction of this ligament becomes necessary to stabilise the patella and reduce the likelihood of future dislocations.
Patients with patella instability should consult their doctor for a comprehensive evaluation of their condition and a detailed discussion of the most suitable treatment options. It is essential to address any concerns or enquiries with the healthcare provider to gain a better understanding of the condition and receive the best possible care.
A MPFL Reconstruction is recommended for those who have had one or more patellar dislocations and have ongoing knee instability.
If there are coexisting bony deformities, the MPFL reconstruction is usually not a sufficient option, and additional procedures might be necessary.
Like any surgery, MPFL Reconstruction comes with both potential benefits and risks. The decision to undergo the procedure should be made in consultation with a skilled orthopaedic surgeon, and the patient’s specific circumstances will influence the potential outcomes. Here are some of the benefits and risks associated with MPFL reconstruction:
Medial Patellofemoral Ligament (MPFL) reconstruction can be performed using different surgical approaches depending on the patient’s specific condition and the extent of the procedure. Here are some common surgical approaches for MPFL reconstruction:
Arthroscopic Approach: Arthroscopy is a minimally invasive surgical technique that involves using small incisions and a tiny camera (arthroscope) to visualise and perform the procedure. In the context of MPFL reconstruction, the arthroscopic approach allows the surgeon to work inside the joint with minimal disruption to the surrounding tissues.
Open Surgical Approach: In some cases, open surgery may be necessary, especially when there are additional structural issues or complex anatomical abnormalities that need to be addressed alongside MPFL reconstruction. Open surgery involves making a larger incision, providing more direct access to the knee joint. It may be employed when arthroscopic techniques are insufficient to address the patient’s condition adequately.
Combined Approaches: Some surgeons may use a combination of arthroscopic and open techniques, depending on the specific requirements of the surgery. For instance, arthroscopy may be used to assess the joint and perform initial steps, while open surgery may be employed for more extensive reconstruction or adjustments to the bony structures.
The choice of surgical approach will depend on factors such as the patient’s unique condition and the extent of the damage or deformity.
For MPFL reconstruction a tendon graft is used. It can be taken from own patient’s tissues (autograft), from a tissue bank (allograft), or a synthetic ligament can be used.
Professor Al Muderis has revolutionized MPFL Reconstruction by introducing a minimally invasive technique using LARS ligaments (Ligament Augmentation and Reconstruction System). that mimic natural knee ligament fibres. It can significantly reduce surgery time since there’s no need for additional graft harvesting. As a result, patients can expect a faster return to full function
Following the surgery, patients will be taken to the recovery room for monitoring. Once their condition stabilises, they will be transferred to the ward. Pain management will be administered.
Patients will be encouraged to start moving their knee and walking within a day or two of the surgery. The surgical wound dressing will usually be reduced on the second day post-op to make movement easier. A physiotherapist will be available to guide them through exercises and assist with rehabilitation and mobility.
The expected hospital stay after the surgery is approximately one to three days.
During the first week after surgery, the leg may be swollen, and the knee may feel stiff. It is normal to require regular pain medication during this period. Patients are advised to diligently perform the prescribed exercises at home to optimise recovery following surgery. The most important part of rehabilitation is maintaining strength and motion. Weight-bearing as tolerated, with crutches will be advised for an initial period after surgery.
Follow-Up: Regular follow-up appointments with the team will help monitor your progress and address any concerns:
Consistent commitment to the prescribed physiotherapy exercises significantly influences recovery after MPFL reconstruction.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000