The medial patellofemoral ligament (MPFL) connects the patella (kneecap) to the lower end of the femur (thigh bone). This ligament is primarily responsible for anchoring the patella to prevent it from dislocating outside of the knee joint.
The various knee joint structures are intricately arranged in such a way that the knee joint is able to withstand significant amounts of stress every day. The stability of the patella, however, can be compromised in the event of a traumatic blow to the knee joint. A partial or complete tear of the medial patellofemoral ligament (MPFL) disrupts the ligament structure resulting in patellar instability. Athletes that perform pivoting motions as part of their sport are among those with the highest likelihood of sustaining an MPFL injury. Non-athletic individuals can also experience an MPFL injury, particularly if there is an underlying knee joint abnormality or they have weakened leg muscles. Dr. Frank McCormick, orthopedic knee specialist serving Orlando, Palm Beach County, and surrounding Florida communities, has the knowledge and understanding, as well as substantial experience, in treating patients with a medial patellofemoral ligament injury.
Knee pain while sitting is one of the most commonly reported symptoms of a medial patellofemoral ligament (MPFL) injury. More severe injuries may cause a feeling that the knee joint will “give way”. Some other common symptoms of an MPFL injury include:
Dr. McCormick first gathers a comprehensive medical history by discussing any precipitating or prior knee injuries, underlying medical conditions, physical activity level, and current symptoms. A thorough physical examination will follow where the integrity and strength of the medial patellofemoral ligament (MPFL) are evaluated. Imaging studies are also useful diagnostic tools for confirming an MPFL injury. X-rays can identify any bone-related damage that may have occurred from the initial injury. Magnetic resonance imaging (MRI) allows Dr. McCormick to measure the extent of damage to the MPFL as well as assess the surrounding soft-tissue structures for additional damage.
Conservative therapies alone are often sufficient treatment measures for the majority of medial patellofemoral ligament (MPFL) injuries. This includes patients with a normal patellar height at the time of injury, a minimally dislocated patella, or those without any additional knee joint damage. A knee brace or other device is highly encouraged to protect the ligament by immobilizing the knee joint. Modifying or avoiding weight-bearing activities can also prevent any further damage to the MPFL. Non-steroidal anti-inflammatory medications (NSAIDs) and applying ice can diminish any pain and inflammation associated with this injury.
However, surgical intervention may be required in the event of unsuccessful conservative therapy or a complete rupture of the medial patellofemoral ligament (MPFL). A small camera (arthroscope) and specialized surgical instruments can be utilized to surgically repair the MPFL in a minimally invasive procedure. Any damaged ligament fragments are resected, and the remaining healthy tissue is sutured back together or reattached to the bone. Significant or irreparable damage to the MPFL may necessitate the use of a tendon graft, either from the patient (autograft) or donor (allograft), to reconstruct the ligament. The tendon graft provides a surface for new tissue development, so it is important that it be situated as close to the native MPFL as possible.
For more information on medial patellofemoral ligament injuries, or the excellent treatment options available, please contact the office of Frank McCormick, MD, orthopedic knee specialist serving Orlando, Palm Beach County, and surrounding Florida communities.
