Medial patellofemoral ligament reconstruction
Medial patellofemoral ligament reconstruction is a surgical procedure indicated in patients with more severe patellar instability. The medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the superior aspect of the patella. The medial patellofemoral ligament is the major ligament which stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation. This ligament can rupture or become damaged when there is patellar instability. Dislocation can be caused by a direct blow to the knee, twisting injury to the lower leg, strong muscle contraction, or because of a congenital abnormality such as shallow or malformed joint surfaces. Often a combination of factors leads to patellar instability.
Medial patellofemoral ligament reconstruction using autogenous tissue grafts is done by following the basic principles of ligament reconstruction such as:
- Graft Selection: 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 the condyle.
A knee brace should be used during walking in the first 3-6 weeks after surgery. Avoid climbing stairs, squatting and stretching your leg until there is adequate healing of the graft. Rehabilitation exercises, continuous passive motion and active exercises may be recommended.