Rheumatology: Current Research
Open Access

Role of Medial Patellofemoral Ligament Reconstruction in Preventing Recurrent Patellar Dislocations

Donald Kasitinon^{* *}Correspondence: Donald Kasitinon, Department of Orthopaedics, University of Turku, Turku, Finland, Email:

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About the Study

Patellar dislocation is a significant orthopedic issue, especially in athletes. The condition involves the displacement of the kneecap (patella) from its normal position in the trochlear groove of the femur. This event can lead to acute pain, swelling and potential long-term complications if recurrent. One of the most effective surgical interventions for addressing recurrent patellar dislocations is Medial Patellofemoral Ligament (MPFL) reconstruction.

Patellar dislocation occurs when the patella slides out of its groove on the femur, usually laterally. The primary causes of patellar dislocation include traumatic injuries, congenital abnormalities or as a consequence of sports activities. The incidence is notably higher among adolescents and young adults, especially those involved in high-impact sports.

Recurrent patellar dislocations can result from insufficient stabilization of the patella due to weakness or laxity of the surrounding soft tissues, particularly the MPFL. The MPFL is an important ligament that helps to stabilize the patella and prevent its lateral displacement.

Role of MPFL in knee stability

The MPFL is an important ligament in the knee that provides medial stability to the patella. It is located on the inner side of the knee joint and helps keep the patella properly aligned within the trochlear groove of the femur. When the MPFL is injured or weakened, the patella is more susceptible to dislocating laterally [1].

Underlying mechanisms of MPFL reconstruction

The patella’s stability is largely dependent on the integrity of its surrounding soft tissue structures, including the MPFL. The MPFL is a primary stabilizer that resists lateral forces exerted on the patella and helps maintain its central alignment within the femoral trochlea [2]. During activities that involve knee flexion and dynamic loading, such as walking or running, the MPFL is important for preventing excessive lateral displacement of the patella.

Biomechanics of patellar stability

The MPFL’s contribution to patellar stability is rooted in its biomechanical properties. The ligament functions as a passive stabilizer by providing resistance against lateral displacement. Its role becomes particularly pronounced in the context of dynamic knee movements where the forces acting on the patella are variable [3]. The MPFL is most active during the initial stages of knee flexion, when the patella is most susceptible to lateral forces. In this phase, the MPFL helps maintain the patella's alignment and prevents its dislocation.

In cases of recurrent dislocations, the MPFL may be stretched or torn, impairing its ability to stabilize the patella effectively. MPFL reconstruction aims to restore the normal length and tension of this ligament, thereby reestablishing its capacity to resist lateral forces [4]. By reconstituting the structural integrity of the MPFL, the procedure helps to maintain proper patellar tracking and prevent future dislocations.

Clinical considerations

When considering MPFL reconstruction for preventing recurrent patellar dislocations, several clinical factors must be taken into account [5]. These factors include the patient’s age, activity level and the presence of any associated knee abnormalities.

Patient demographics: Young athletes and active individuals are particularly susceptible to patellar dislocations due to their high levels of physical activity and the associated stresses on the knee joint. For these patients, MPFL reconstruction can be a critical intervention to prevent further dislocations and allow them to return to their desired level of activity [2]. In contrast, older adults may experience patellar dislocations due to age-related changes in ligament elasticity and joint integrity. The decision to proceed with MPFL reconstruction in this demographic may be influenced by the patient’s overall health status and activity goals.

Activity level and functional demands: The impact of recurrent patellar dislocations on a patient's functional abilities can vary widely [4]. For individuals who engage in high-impact sports or activities that place significant stress on the knee joint, the prevention of recurrent dislocations is need for maintaining performance and preventing long-term joint damage. MPFL reconstruction can help mitigate the risk of dislocations and improve overall knee function, enabling these individuals to resume their activities with reduced risk of injury [6].

Associated knee abnormalities: Recurrent patellar dislocations may be accompanied by other knee abnormalities, such as trochlear dysplasia or malalignment of the patellar tracking mechanisms. These conditions can contribute to the instability of the patella and may need to be addressed in conjunction with MPFL reconstruction [5]. Accurate assessment and management of these associated issues are important for optimizing the outcomes of the reconstruction procedure and preventing future dislocations [7].

Broader implications for patient management

The implications of MPFL reconstruction extend beyond the immediate prevention of recurrent patellar dislocations. The procedure has broader implications for patient management, including long-term joint health, rehabilitation and overall quality of life [8].

Long-term joint health: Preventing recurrent patellar dislocations through MPFL reconstruction can have significant long-term benefits for joint health. Repeated dislocations can lead to cartilage damage, osteoarthritis and other joint-related complications. By stabilizing the patella and preventing further dislocations, MPFL reconstruction helps to preserve the integrity of the joint and reduce the risk of long-term joint degeneration [9].

Rehabilitation and recovery: Postoperative rehabilitation is an important aspect of the recovery process following MPFL reconstruction. Effective rehabilitation helps patients regain strength, flexibility and function in the knee joint, thereby reducing the risk of future dislocations and improving overall knee stability [10]. A well-structured rehabilitation program should include exercises to strengthen the quadriceps and hamstrings, improve proprioception and improve overall knee function. Patient education and adherence to rehabilitation protocols are need for achieving optimal outcomes and preventing complications.

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