Medial Patellafemoral Ligament Reconstruction

Medial patellafemoral ligament (MPFL) reconstruction is performed for patients who have recurring patella dislocations or subluxations. Using an allograft (cadaver tissue), the knee cap is stabilized in a position where it will move within the groove of the knee and not dislocate.

This procedure is performed in two parts. Initially an arthroscopy of the knee is done to complete a lateral release. This involves releasing tight tissue on the outside of the knee that is pulling the knee cap out to the side and causing the knee cap to dislocate.

Next, the open part of the procedure is performed through two 2 cm incisions along the inside of the knee. An allograft (cadaver tissue) is attached to the knee cap using a screw and then is secured to the inside aspect of the knee with another screw. Both of the screws are absorbable. This recreates the ligament, which prevents the knee cap from dislocating out to the side.

Postoperative Instructions:

MOVEMENT

  • You will be placed in a knee immobilizer brace after your surgery. You are to wear this at all times except when bathing. The brace will be preset to limit the movement of your knee. Do not force the motion though because this will likely cause pain.

MEDICATIONS

  • An injection of local anesthesia was injected into your knee after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
  • The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.
  • A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your dressing is water-proof; you can shower as soon as the day after surgery. Do NOT submerge in a bath tub however; only shower and allow water to run over your dressing and pat it dry.
  • Your dressing will be removed at your first post-operative visit at which point you will be able to get your incisions wet.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to two hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Your stitches will be taken out. You will continue icing the surgical area two to three times a day (or more if needed). Your knee brace will locked so you can’t bend your knee for the first two weeks after surgery.

Two weeks post op: Second follow-up visit. Your knee brace will be unlocked at this time. You will be allowed to move from 0 to 45 degrees of flexion.

Four weeks post-op: Third follow-up visit. Your knee brace motion will be increased to allow for 0 to 60 degrees of flexion.

Six weeks post-op: Fourth follow-up visit. Time to discontinue the brace. Physical therapy will start to improve range of motion.

Twelve weeks post-op: Fifth follow up visit. Range of motion should be full. Continue physical therapy to work on strengthening.

Sixteen weeks post-op: Sixth follow-up visit. Range of motion and strength testing. There should be no feeling of instability in the knee. Pain should be mostly resolved at this point.





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