MPFL Reconstruction for Patellofemoral Maltracking

Ideal candidates for MPFL reconstruction are individuals with patellofemoral maltracking due to a compromised MPFL. This may include those who have anatomical defects predisposing them to patellar instability, such as patella alta or trochlear dysplasia.

MPFL Reconstruction involves replacing the damaged ligament with a graft, either from a donor (allograft) or from the patient’s own tissue (autograft). After performing knee arthroscopy to assess the knee’s condition, the graft is anchored to both the patella and the femur, effectively replacing the damaged MPFL. This re-establishes the “tethering effect,” ensuring the patella tracks centrally within its groove on the femur, reducing the risk of maltracking.

Typically, light activities and desk jobs can be resumed within a few weeks post-surgery. For high-impact sports or physically demanding jobs, a full recovery may take several months. This allows ample time for the ligament to heal and for strength and function to be restored through physical therapy.

Post-surgery, you will recover from anesthesia and can go home the same day. The knee will be immobilized in a brace, and crutches may be used initially. Pain medication will be prescribed to manage postoperative discomfort.

Physical therapy is a cornerstone of recovery and follows a phased approach:

• Early Stage (Weeks 1-4): Focuses on reducing swelling, managing pain, and restoring initial range of motion.
• Middle Stage (Weeks 4-12): Introduces weight-bearing and strength-building exercises.
• Late Stage (Weeks 12 and beyond): Incorporates sport or activity-specific exercises to prepare you for a full return to previous activities.

As with any surgical procedure, there are inherent risks, although these are generally rare:

• Infection: Antibiotics administered during surgery minimize this risk.
• Blood Clots: Occur rarely; preventive measures include post-operative aspirin.
• Nerve Damage: Very rare but could lead to leg or knee numbness.
• Graft Failure or Re-dislocation: This is infrequent but may occur, often requiring additional surgical intervention.

If left untreated, ongoing patellofemoral maltracking can lead to:

• Further Instability: Continual misalignment can result in more severe problems.
• Increased Damage: Progressive instability can cause further damage to cartilage or joint structures, leading to arthritis over time.