MPFL (Medial Patellofemoral Ligament)

MPFL reconstruction is a form of patellar stabilisation surgery that can be used when the medial patellofemoral ligament is torn. It can reduce the risk of the kneecap becoming displaced or dislocated. The surgery can also ensure that you are able to recover as much mobility as possible.

When is it Performed?

The medial patellofemoral ligament is a tough band of tissue that helps to keep the kneecap in place. If the MPFL is damaged, the kneecap can slide out of alignment. The most common cause of a torn MPFL is a sports injury, but any injury that involves twisting or an impact on the knee could affect the ligament, especially if the kneecap is dislocated. In some cases, problems with the MPFL can be caused by having naturally loose ligaments or abnormalities in the knee or hip joints. A torn MPFL can cause pain, instability, restricted mobility and other symptoms. Surgery isn’t always required to reconstruct the MPFL, but it may be recommended if the damage is severe and other treatments such as physiotherapy haven’t helped. Patellar stabilisation surgery can also reduce the risk of further damage to the knee if it is unstable. Surgery is often the best choice if there have been repeated dislocations of the kneecap due to the torn MPFL.

The Procedure

MPFL reconstruction is usually performed as an arthroscopic procedure through several small incisions, although open surgery is sometimes necessary. You will usually be given a general anaesthetic during the operation, but a spinal anaesthetic may be used instead. Occasionally a torn ligament can be repaired soon after it is damaged but usually a graft will be used as a reconstruction. The graft will usually be a tendon taken from your hamstring. The graft will be attached to the patella to provide a “check rein”. Mr Dawson will ensure that the graft has the right tension and range of motion. Once the surgical incisions have been closed, your body will begin to regenerate the ligament along the graft.

You will need to use crutches for a few days after MPFL surgery but no brace is usually required. Physiotherapy will then help you to recover your strength and mobility over the following three to four months.

Risks and Benefits

• All surgery carries a small risk of complications such as blood clots, infection and adverse reactions to the anaesthetic. The risks are lower for arthroscopy than for open surgery and they will be explained in detail by the doctor.
• MPFL surgery should help to relieve problems such as pain, instability and reduced mobility. You should be able to return to your usual activities once you have recovered. However, there can sometimes be some stiffness or difference in mobility.
• Reconstructing the ligament can reduce the risk of further problems with the kneecap, including dislocations and arthritis.

MPFL Physio Protocol

Download MPFL Physio Protocol

If you would like to discuss MPFL surgery with an experienced doctor, make an appointment with Mr Matt Dawson at the Cumbrian Knee Clinic.