Medial Patellofemoral Ligament Injury

What is a Medial Patellofemoral Ligament Injury?

The medial patellofemoral ligament (MPFL) is a ligament that joins the kneecap (patella) to the thighbone (femur). Ligaments are fibrous connective tissue that attaches bones to other bones. The MPFL is attached to the inside of the patella and helps stabilize it and position it in a groove at the lower end of the femur called the trochlea. Trauma or a blow to the knee may cause a tear in the MPFL ligament.

What are the causes of MPFL?

The most common cause of MPFL injury is dislocation during high-impact sporting events. Sometimes MPFL can be due to underlying abnormality, ligament laxity, or weak muscles. Most of the time individuals with a sports background have a high chance of risk.

Symptoms of a medial patellofemoral ligament injury include:

• Knee stiffness
• Swelling
• Pain
• Tenderness
• Knee instability
• Shifting of the patella
• Catching sensation on bending and straightening the knee
• Difficulty walking
• Cracking or crunching sound
• Restricted range of motion
• Discoloration near the injured area
• Bruising

Diagnosis

Your doctor will review your medical history and perform a physical examination where the knee and patella are assessed for range of motion, strength, and stability. Your doctor may also recommend imaging tests such as X-rays, CT scans, or an MRI scan to visualize the ligament injury and any damage to other structures.

Treatment

The doctor usually prefers first-time dislocation with non-surgical methods and recurrent dislocations need surgical reconstructive procedures.

Non-Surgical Treatment

The initial injury (first-time dislocations) can be treated quickly without surgery by applying plaster to the knee, right after the accident. The knee is immobilized using a splint and plaster for a couple of weeks to heal. Once the plaster is removed, the doctor might prescribe physical therapy and exercises to strengthen the knee muscles and remove stiffness of the knee.

However, repeated injuries and instances of instability might need the help of surgical interventions to heal.

Surgical Treatment

The repeated kneecap instability and the ineffectiveness of the non-surgical method will make the doctor opt for surgery. Knee surgery depends on the extent of damage to the knee and other factors like the patient’s health, medications, and the patient’s regular activity. The doctor might try to perform a repair procedure by reattaching the torn ligament to its original position on the bone.

The doctor might also go for MPFL Reconstruction surgery if the injuries are more complex. The surgery usually takes a couple of hours and the patient can be discharged either the same or the next day with their knee in a brace. The patients can resume their normal activities within 3 to 6 weeks after the surgery.

In this procedure, the doctor takes a graft tissue from another part of the body and then replaces the torn ligament with this graft. This procedure is a minimally invasive surgery called arthroscopy. The torn tissue in the joint is cleaned up and the ligament on the outside of the kneecap joint is loosened. Most of the patients experience great improvement in the kneecap joint’s stability after this surgery.