Medial Patellofemoral Ligament (MPFL) Reconstruction

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Dr. Manish Maheshwari is an Orthopaedist and
Sports Medicine Surgeon in Indore and has an
experience of more than 13 years in these fields.
Dr. Manish Maheshwari practices at Global SNG
Hospital in South Tukoganj, Indore. He completed
graduation post Graduation from Mahatma Gandhi
Memorial Medical College Maharaja Yashwant Rao
Hospital, Indore in 2005. He worked in major
hospitals of Mumbai like Lilavati Hospital
Kokilaben Dhirubhai Ambani Hospitals.
ADDRESS
Indore Arthroscopy Center
16/1, South Tukoganj, Global SNG Hospital,
Indore PHONE [phone] EMAILmmanish15_at_gmail.co
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Medial Patellofemoral Ligament (MPFL)
Reconstruction
Introduction- 
The Medial Patellofemoral Ligament is a 
ligaments made of group of bands of retinacular
tissues that is an hour shaped ligament. This
ligament play an important role and stabilization
and support to the medial aspect of the Patella
bone. Most importantly it acts during the early
stages of knee flexion, it is the critical
component in patellar tracking and its stability
that is within the trochlear groove. Attachments
-  This ligament is located in the second layer
of the three soft tissue layer that is within the
medial aspect of the knee. It originates from the
shape that is running between the adductor
tubercle, that is superior to superficial medial
collateral ligament. There is a broad insertion
of the MPFL onto the superomedial aspect of
Patella that is (20-30mm). There is proximal
insertion that extends to quadricep tendon and
the distal insertion crosses deep to distal
vastus medialis obliques which has average length
of 56mm.
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How the medial patellofemoral ligament gets
injured?- 
Any MPFL injury or tear can be a result of any
underlying knee abnormalities or can be due to
weakening of leg muscles. MPFL is the most
commonly injured ligament during any high impact
contact sporting including tackles and pushes.
During any MPFL injury the patella bone
dislocates and there are tears in the ligament on
inside of the knee. These types of tears and
injuries always occur when the knee joint is
straight and is slightly bent and the kneecap is
forced extremely out of the specific place.
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Symptoms of torn MPFL-
Mostly the MPFL tears are due to traumatic
dislocations and some are because of unidentified
injuries, certain symptoms of torn MPFL are-

• Extreme pain in the kneecap.
• Pain during any activity
• Swelling over the knee joint
• Instability of knee joint
• Stiffness
• Lock-in of knee joint for long time
• Bone crepitus sound
• MPFL reconstruction- 

The MPFL reconstruction is a typical surgical
procedure that is used in correcting MPFL tears
or reoccuring kneecap dislocations.  There are
several techniques which are involved in the
reconstruction process, but the most common
technique involves using a tissue graft to
reconstruct the torn ligament that helps to hold
the kneecap in the correct position and to make
proper articulation with the femur bone.
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Other procedures involve the reconstruction of
MPFL in which there is a new MPFL is created that
keeps the knee stabile and protect the joint from
any other further additional damage.     

• Patient with MPFL tears generally go through an
  assessment that basically start with the physical
  condition and past medical history, basic
  investigation and MRI is performed to understand
  the condition of the ligament. MPFL
  reconstruction has excellent results and also is
  a way better technique with the low rate of
  complications, this is a safe procedure with very
  rare or no risk factors. 
• Certain techniques that are used in
  reconstruction are-
• Arthroscopic surgery - that's a minimal invasion
  surgery in which the damaged part or the torn
  part is being cleaned and replaced, this is the
  best available option as there are no chances of
  infection, Along with this it's done using light
  invasions which heels faster.
• Medial imbrication - it's a procedure in which
  the MPFL is being tightened that procedure is
  called the tucking process.
• Lateral release- this procedure generally
  involves loosening of the outer part of the
  patellofemoral ligament that helps in better
  recovery.

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Recovering after Medial Patellofemoral Ligament
(MPFL) Reconstruction-
As a reconstructive surgery it's a complex
procedure that needs time to heal, post surgery
the knee will be immobilized and complete bed
rest will be suggested as to avoid further
progressions and complications. The average
healing time after this procedure is 2 to 3
months , the earliest healing phase include
NSAIDs for the next 2 months, the patient is
advised to take rest up to 1 month post surgery
as this can affect the healing process which can
lead to recurrent injuries, light activities are
being prescribed after a certain time it can help
to enhance the joint mobility and better
contraction. Light activities including
supportive walking, Range of motion enhancing
exercise, stretching, passive muscle
strengthening exercises are being prescribed.  To
reduce pain and stiffness braces and physical
agent modalities are being prescribed.  Most of
the times people return to normal routine and
sport's after 4-5 months post MPFL Reconstruction
surgery, the recovery also depends upon how the
pateint is Caring and being introduced to
precautionary measures. The recovery process
often takes times in cases where there are
reoccuring injuries or the patient is not aware
of any internal manifestation in the joint.
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Dr. Manish Maheshwari is one of the Best knee
doctors near me in Indore at low cost. If you are
searching for Best orthopedic surgeon in Indore
for arthroscopic knee surgery, then come to
Indore Arthroscopy Center. For Appointment
9826252228 more information visit our site-
https//www.drmanishmaheshwari.com/
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