Understanding MPFL Surgery: Purpose, Procedure, and Recovery

What Is MPFL Surgery and Why Is It Performed?

Medial patellofemoral ligament (MPFL) surgery is a specialised orthopaedic procedure aimed at correcting patellar instability. The MPFL is a key ligament that holds the kneecap (patella) in the correct position, preventing it from dislocating or moving outwards. Patients with recurrent patellar dislocation, especially younger athletes or individuals with specific anatomical or traumatic factors, often develop symptoms of instability that do not respond to physiotherapy alone. In these cases, MPFL reconstruction surgery provides a solution by recreating or reinforcing the ligament using a tendon graft. The main goal is to restore proper patellar tracking, improve knee function, and reduce the risk of future dislocations. Early diagnosis and intervention can be vital in preventing long-term damage to knee cartilage and function, thus preserving an active lifestyle.

Potential Risks and Post-Operative Complications of MPFL Surgery

As with any surgical procedure, MPFL reconstruction comes with potential side effects and complications. Short-term complications may include swelling, pain, haemarthrosis (bleeding into the joint), and stiffness, which are usually well managed with aftercare and physiotherapy. A common concern among patients is knee stiffness following MPFL surgery, often caused by post-operative swelling, scar tissue formation, or not adhering to physiotherapy exercises. Long-term complications are rare but may involve persistent instability, patellar maltracking, hardware irritation, infection, or deep vein thrombosis. In some cases, excessive tightness or laxity of the new ligament may cause restricted movement or, conversely, recurrent instability. Adhesions and scar tissue around the surgical site can also contribute to chronic stiffness, affecting the knee’s range of motion if not addressed early.

Reducing Risks: Patient Safety and Preventative Strategies

Patient safety is a top priority in MPFL reconstruction surgery. Surgeons employ minimally invasive techniques, use sterilised equipment, and follow stringent protocols to minimise infection risk. Accurate diagnosis of associated knee injuries, such as cartilage damage or alignment problems, is crucial to ensure customised surgical planning and avoid complications. Preoperative planning may include X-rays and MRI scans to identify anatomical factors that could increase post-operative risk. Patients are encouraged to share their full medical history, allergies, and medication use with the surgical team. Post-operatively, adhering to wound care advice, attending scheduled follow-ups, and reporting unusual symptoms such as fever, extreme pain, or redness around the surgical site ensures prompt intervention and reduces the risk of long-term complications.

Recognising Warning Signs: When to Seek Immediate Medical Advice

While mild bruising, discomfort, and swelling are common after MPFL surgery, patients should be vigilant for warning signs of serious complications. If the knee becomes increasingly stiff, hot, red, or swollen, or if there is relentless pain not relieved by prescribed medication, immediate medical attention is required. Sudden inability to move the knee, a popping sensation, or a feeling that the kneecap is unstable may signal a problem with the graft or fixation. Systemic symptoms such as high fever, chills, or breathlessness could signal infection or a blood clot and should not be ignored. Early intervention for these complications can prevent permanent damage and ensure the best possible recovery outcomes.

Long-Term Prognosis and Reducing Recurrence of Complications

The majority of MPFL surgery patients achieve excellent outcomes, with marked improvement in knee stability and function. However, long-term prognosis relies on appropriate postoperative care, patient adherence to physiotherapy protocols, and routine monitoring for potential problems. Following recommended knee exercises, avoiding sudden twisting or high-impact activities in the early recovery phase, and maintaining a healthy weight all help protect the new ligament and reduce complication risks. In rare cases, further procedures may be required to address persistent pain, restricted movement, or instability. Regular consultations with your orthopaedic specialist are essential to spot and address any recurring symptoms early, ensuring the longevity of the repair and ongoing knee health.

Frequently Asked Questions: MPFL Surgery Risks and Safety

Why does my knee feel stiff after MPFL surgery?

Knee stiffness after surgery is common and often results from joint swelling, scar tissue formation, or limited early movement. Gradual physiotherapy, regular gentle exercises, and timely pain management help restore your knee’s range of motion. If stiffness persists, inform your healthcare team promptly.

What signs may indicate a complication after MPFL surgery?

Watch for increased redness, swelling, continuous severe pain, wound discharge, high fever, or sudden difficulty moving the knee. Also, sensations of instability or a popping sound in the knee warrant early medical assessment to rule out issues with the graft or fixation.

Can infection occur after MPFL surgery?

Although rare due to sterile surgical techniques, infections can develop at the incision site or inside the joint. Signs include increased redness, heat, pus, or fever. Early antibiotic treatment is highly effective, but persistent or deep infections may require further intervention.

What is the likelihood of re-dislocation after surgery?

Re-dislocation following MPFL surgery is uncommon but possible, especially if anatomical factors weren’t addressed or rehabilitation was inadequate. Proper patient selection, surgical technique, and post-operative physiotherapy greatly reduce this risk and promote long-term success.

How can I prevent stiffness and other complications at home?

Follow your rehabilitation plan, avoid immobilising the knee for extended periods, and attend all scheduled physiotherapy appointments. Maintaining good general health, including adequate hydration, nutrition, and gentle activity, promotes healing and reduces complications.

Should I be worried about blood clots after MPFL surgery?

Blood clots are rare but possible following lower limb surgery. Early movement, wearing compression stockings, and following your doctor’s advice are effective preventative measures. Seek immediate help if you experience calf swelling, redness, or chest pain after surgery.