Patella Instability Reconstruction Surgery
What is patella instability reconstruction surgery?
Medial patellofemoral ligament (MPFL) reconstruction is a minimally invasive technique that shows promise for patients with recurrent patella (kneecap) dislocations. A patella dislocation occurs when the kneecap is pulled out of the groove on the end of the thigh bone. Once a patella dislocation occurs, it is much more likely to occur again in the future. Multiple dislocations can damage cartilage in the knee, leading to early onset arthritis.
In this procedure, the surgeon uses a tendon graft to re-create the function of the native MPFL. The graft is made from either the patient's own tissues (called an autograft) or from donor tissues (called an allograft). It restores natural anatomy and allows the patella to move without any realignment issues.
The knee is the largest joint in the body and one of the most complex. It is made up of the femur (thighbone), tibia (shinbone) and patella. The MPFL is the major ligament that stabilizes the patella and helps prevent dislocation. When the kneecap dislocates, the MPFL is always torn.
When is surgery recommended?
Anyone who has had multiple patellar dislocations or recurrent feelings of instability is a potential candidate for MPFL surgery. The procedure is also recommended for patients for whom surgery to repair a dislocated patella has failed. But it's important to consider non-surgical treatments first, such as bracing to immobilize the knee or physical therapy to strengthen surrounding muscles. At the time of evaluation, the patients' limb alignment will also be assessed. To optimize outcomes, corrections of malalignment are occasionally recommended at the time of MPFL reconstruction as well.
What is the recovery time?
Recovery from MPFL reconstruction varies by patient and the type of tendon graft (autograft or allograft) used to reconstruct the ligament. It typically involves four to six weeks on crutches with extensive physical therapy to regain range of motion, strength and balance. With appropriate rehabilitation, patients can return to sports in three to four months. As with all surgical procedures, recovery varies by patient and demand.