Patellofemoral instability, characterized by the abnormal movement or dislocation of the kneecap (patella), can significantly impair a person’s ability to perform daily activities and participate in sports or physical activities. Among the various treatment options available, medial patellofemoral ligament (MPFL) realignment has emerged as a highly effective surgical intervention for patients with severe patellofemoral instability. By restoring stability to the patellofemoral joint, MPFL realignment helps alleviate pain, improve knee function and prevent recurrent dislocations.

What Is Patellofemoral Instability?

Before going into the specifics of MPFL realignment, it is crucial to understand the underlying mechanisms of patellofemoral instability. The patella, or kneecap, is a small bone that sits in front of the knee joint and moves within a groove at the end of the thigh bone (femur). Patellofemoral instability occurs when there is an imbalance in the forces acting on the patella, leading to abnormal tracking or dislocation.

Factors contributing to patellofemoral instability may include anatomical abnormalities, such as a shallow or misaligned groove in the femur, as well as muscular imbalances or ligament laxity around the knee joint. Recurrent patellar dislocations can cause further damage to the surrounding structures, exacerbating the instability and pain experienced by the patient.

The Role of the Medial Patellofemoral Ligament (MPFL)

The MPFL is a critical stabilizing structure on the medial (inner) side of the knee joint, responsible for preventing excessive lateral (outward) movement of the patella. When the MPFL is torn or stretched due to injury or repeated dislocations, patellofemoral instability can occur. Restoring the integrity of the MPFL is essential for restoring normal patellar tracking and stability.

MPFL Realignment Surgery

MPFL realignment surgery involves repairing or reconstructing the torn ligament to restore its function and stabilize the patella. During the procedure, the surgeon may use techniques such as suture repair or graft reconstruction to reattach the MPFL to its proper anatomical position. In cases of severe instability or chronic dislocations, additional procedures, such as trochleoplasty (reshaping of the groove in the femur) or tibial tubercle osteotomy (realignment of the shin bone), may be performed to optimize patellar tracking and stability.

Benefits and Outcomes

MPFL realignment offers several benefits for patients with severe patellofemoral instability. By restoring stability to the patellofemoral joint, this surgical intervention helps alleviate pain, improve knee function, and reduce the risk of recurrent dislocations. Studies have shown favorable outcomes with MPFL realignment, including improvements in patellar tracking, range of motion, and patient satisfaction.

Medial patellofemoral ligament realignment plays a crucial role in the comprehensive management of patellofemoral instability. By addressing the underlying anatomical and biomechanical factors contributing to instability, MPFL realignment surgery offers patients a chance to regain pain-free function and return to their desired level of activity. As with any surgical procedure, it is essential for patients to undergo a thorough evaluation by a qualified orthopedic surgeon like Dr. Steven Struhl to determine the most appropriate treatment approach based on their individual needs and goals. If you have struggled with patellofemoral instability, contact Steven Struhl, MD – Shoulders & Knees in NYC or Westchester, NY, to schedule a consultation with Dr. Struhl.