Medial Patellofemoral Ligament Anatomy
The medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the medial aspect of the patella. It helps stabilize the patella and can become stretched out and incompetent in the setting of patellar instability.
What is Medial Patellofemoral Ligament Reconstruction?
Medial patellofemoral ligament reconstruction is a surgical procedure used to augment the native MPFL to help compensate for an underlying anatomic abnormality or in conjunction with other procedures to help retension the medial patellar restraints.
Medial patellofemoral ligament reconstruction is performed by following the basic principles of ligament reconstruction such as:
Graft selection: A strong and stiff graft should be selected.
Location: The graft should be located isometrically.
Correct tension: The tension set in the graft should be appropriate.
Secure fixation: Stable fixation of the graft should be achieved.
Avoid condylar rubbing or impingement: The graft should not rub against condyle or cause impingement.
Medial Patellofemoral Ligament Reconstruction Procedure
The procedure involves securing a tendon graft, typically a tendon graft from a donor, between the medial aspect of the patella and femur. This is typically done through two separate incisions and is done in conjunction with a lateral retinacular lengthening. Sometimes other procedures such as a trochleoplasty or patellar tendon imbrication are performed as well.
Postoperative Care After Medial Patellofemoral Ligament Reconstruction
Immediate weight bearing and range of motion is commenced after sugery. Crutches are used for comfort. Physical therapy starts within 1-2 weeks and if rehab proceeds well enough, impact activities can start as early as 6 weeks after surgery.