An Overview on Lateral Patellar Instability and MPFL Reconstruction
The knee is a complex joint composed of bones, articular cartilage, ligaments, tendons and other supporting structures. The medial patellofemoral ligament (MPFL) is part of this sophisticated structure. The MPFL is responsible for attaching the inside portion of the patella (kneecap) to the femur. An injury to the MPFL occurs when the kneecap dislocates or subluxes, often caused during athletic activities or other traumatic events, and may lead to lateral patellar instability. Patients living in the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area experiencing ongoing kneecap dislocations caused by lateral patellar instability may be candidates for a surgical procedure known as MPFL reconstruction. Dr. Nikhil Verma, knee surgeon, specializes in this innovative treatment in order to return full function and stability to the knee joint.
What is Lateral Patellar Instability?
Lateral patellar instability is almost always caused by a kneecap dislocation during a traumatic event or sports activity. During a dislocation, the kneecap slips out of the lateral (outside) aspect of the knee. The dislocation almost always occurs with the knee at a straight angle or at a shallow degree of knee flexion, rather than at a bent angle. When the kneecap dislocates, it often tears the medial patellofemoral ligament and other surrounding soft structures.
Lateral Patellar Instability Symptoms
Patients experiencing lateral patellar instability report the sensation of the kneecap slipping with twisting and turning movements, as well as pain in the kneecap with activity and when palpated. Certain patients may also experience a near kneecap dislocation when the knee is close to being straight.
Lateral Patellar Instability Diagnosis
If lateral patellar instability is present after a kneecap dislocation, a knee surgeon must diagnose the damage and overall condition of the affected knee in order to develop a treatment plan. Dr. Verma will perform a thorough medical history review and physical examination in order to determine the level of instability. X-rays and an MRI scan are also commonly performed to view the injured joint in great detail and to determine if MPFL reconstruction is required.
MPFL Reconstruction as a Treatment Option for Lateral Patellar Instability
Many patients experiencing lateral patellar instability will begin treatment with non-surgical measures such as rest and rehabilitation exercises. However, patients who are young and have experienced ongoing kneecap dislocations, or patients with trochlear dysplasia or patella alta, often require a MPFL reconstruction to return full knee stability and function.
Medial patellofemoral ligament (MPFL) reconstruction is reserved for patients with recurring and serious kneecap dislocations. During the procedure, a knee surgeon reconstructs a new MPFL with a ligament from another part of the patient’s body or from a synthetic graft. The new ligament is created to stabilize the knee and help protect from ongoing dislocations and additional damage.