MPFL Reconstruction

What is the MPFL?

The medial patellofemoral ligament (MPFL) is a knee structure that holds the patella (kneecap) in place on top of the femur (thigh bone). The MPFL is responsible for keeping the kneecap from moving or dislocating to the outside of the knee. Located in the center of the knee and running from the femur to the middle of the patella, the MPFL acts like a strong rubber band, having elastic-like qualities that help stabilize the kneecap when the knee moves. If the MPFL is injured or torn, Dr. Benedict Nwachukwu, orthopedic knee surgeon, may recommend an MPFL reconstruction for patients in Manhattan, New York City or the surrounding New York boroughs.

How does the MPFL become injured?

An MPFL injury most commonly occurs when the kneecap is forced away from its place on the knee. Sporting events, that involves pivoting, like football, basketball, racquetball and tennis can be the cause of a medial patellofemoral ligament tear. A MPFL tear can also be the result of an underlying knee abnormality or weak leg muscles that increase the risk for a kneecap dislocation. When the patella dislocates, it tears the MPFL structure on the inside of the knee.

What is an MPFL Reconstruction?

Patients in New York who have experienced a complete tear of the medial patellofemoral ligament can have an MPFL reconstruction to restore stability to the kneecap. During this procedure, Dr. Nwachukwu replaces the torn ligament with a tendon that can be taken from the patient (called an autograft) or from a donor (called an allograft). An MPFL reconstruction, when performed properly, has excellent patient outcomes and can be done for patients of all ages.

Who should have an MPFL reconstruction?

MPFL reconstruction surgery is reserved for patients who have:

• Recurrent kneecap dislocations
• An unstable patellofemoral joint
• A torn or ruptured medial patellofemoral ligament

How is an MPFL Reconstruction done?

MPFL reconstruction is done with a combination of arthroscopic and open surgery. During this procedure, Dr. Nwachukwu will commonly use an allograft tendon to restore the patient’s MPFL anatomy. An arthroscope is first used to visualize the area of damage, then the actual reconstruction is performed through two small incisions.  The femoral and patella attachments of the MPFL are visualized and prepared in order to receive the new graft. Dr. Nwachukwu will then place two small anchors into the patella, which will hold the tendon graft in place. Dr. Nwachukwu will then drill a small tunnel in the femur, where the graft is inserted and secured with special surgical screws. An MPFL Reconstruction typically takes 60 to 90 minutes and patients usually go home the same day.

How long is the recovery after MPFL Reconstruction?

Patients can expect the following after a medial patellofemoral ligament reconstruction:

• The patient will be placed in a brace to immobilize the knee and protect the new, healing ligament.
• Pain medication may be prescribed to be taken as directed.
• Ice and elevation may help with swelling and discomfort the first day.
• Patients will be weight bearing as tolerated with the assistance of crutches for approximately 6 weeks following surgery.
• After 6 weeks, Dr. Nwachukwu will assess the patient and if proper healing has occurred, a stationary bike may be used with physical therapy in order to restore strength to the quadriceps muscles.
• Most patients can return to normal work and sports activities 5-7 months after surgery.

For more resources on medial patellofemoral ligament (MPFL) reconstruction, please contact the office of Benedict Nwachukwu, MD, orthopedic knee surgeon serving Manhattan, New York City and the surrounding New York boroughs.