PATELLAR INSTABILITY SURGERY

PATIENT STORIES

Mackenzie - ACL Reconstruction, ACL Injury Patient

When I tore my ACL I wasn’t sure if I could return to playing my favorite sports at the same level as before. I went to see Dr. Ahmad at Columbia Orthopedics and he reassured me that after surgery and some hard work I would be able to return to playing at the same level or even better. 6 months later I… Read more “Mackenzie – Hockey – ACL Reconstruction”

Samantha - ACL Reconstruction, ACL Injury Patient

Like many young female athletes, Samantha is a force. Samantha can traverse a soccer field in record time, outmaneuvering her competition. But also like other female athletes, she is susceptible to ACL injuries. At the Center for Pediatric and Adolescent Sports Medicine, Christopher Ahmad, MD is conducting research to determine why the gender difference exists. He instructs his patients that one of the… Read more “Samantha – Soccer – ACL Reconstruction”

Vicki Zucker was a 13-year-old female, extremely competitive in basketball, when she came to see Dr. Ahmad. She played on multiple teams in multiple leagues, and she was diagnosed with left patella instability at the age of 9. She was having difficulty with her basketball, and daily episodes of instability. “My parents went to 7 other Orthopaedic surgeons before meeting… Read more “Vicki – Basketball – Patellar Stabilization”

Garrett Ossolinkski – ACL Reconstruction Patient of Dr. Ahmad
Garrett Ossolinkski
Kevin Finnegan

VIDEOS

OVERVIEW

Medial Patellofemoral Ligament (MPFL) Reconstruction Surgery

Reconstruction of the medial patellofemoral ligament (MPFL) is for patients who may have experienced a tendon tear that is causing recurring knee patellar instability. MPFL injury is commonly attributed to acute traumatic patellar dislocation—when the knee cap suddenly moves out of place.

A common sign that surgery may be necessary, is continued knee instability despite attempts at non-operative treatment. Nonsurgical treatment usually includes wearing a brace in conjunction with targeted physical therapy. Reconstructive surgery is also considered as a solution if you are suffering from a mild bone malalignment.

Your MPFL is: A tendon on the inside of your knee’s medial side that connects your kneecap (patella) to your thigh bone (femur), and stabilizes your knee by preventing lateral displacement of your kneecap.

Bone malalignment: The displacement of bones out of line in relation to joints.

The Facts on MPFL Reconstructive surgery:
  • Lateral patella dislocations are common injuries seen in active young patients.
  • It is necessary to treat associated cartilage injury in conjunction with the MPFL reconstruction surgery
  • Patients who may not respond well to MPFL reconstruction are those with extreme malalignment and patellofemoral arthritis. Dr. Ahmad offers other procedures in these situations
  • An MRI is the most common means to assess MPFL damage
Symptoms

The following symptoms are commonly reported from patient with an MPFL injury:

  • Feeling unstable, or shaky when using the affected knee
  • A sensation that the kneecap is moving to the side during movement
  • Swelling of the knee
  • Restricted range of motion
  • Pain when moving the joint
  • Pain, stiffness, or “locking,” after sitting for a prolonged period of time.

EVALUATION BY TEAM AHMAD

Dr. Ahmad and his team of health professionals will greet you and start your visit with a discussion of your symptoms, sport, level of competition, desired activity level, and mechanism of injury. Next, the doctor will exam your knee, focusing on:

  • The severity of swelling
  • Range of motion
  • MPFL tenderness
  • Muscle strength
  • General knee alignment
  • Degree of looseness of the patella

In some situations, Dr. Ahmad may order an MRI scan to determine the severity of the MPFL tear.

TREATMENT OPTIONS

When you elect to have reconstructive surgery to repair your damaged MPFL, your procedure will typically include two phases, the first being the actual surgery, and the second being the process of recovering properly form the surgery. This second phase is known as the rehabilitation phase.

Surgical

Reconstructive surgery of an MPFL tear generally includes:

  • Diagnostic Arthroscopy: A procedure used to assess the damage to your knee and its tendons, specifically it looks for any intra-articular abnormalities, including cartilage damage around the kneecap joint.
  • Chondroplasty: If cartilage damage is found, this procedure uses a small instrument to shave off cartilage flaps. Some situations require cartilage restoration. Please visit {Insert Link} for more information.
  • Reconstruction: This entails making incisions to expose the MPFL, and using screws and pins to realign and reattach the kneecap and the torn tendon. 



Rehabilitation and Recovery

One of the most important parts of surgery is the post-operation recovery process, known as rehabilitation or rehab. For MPFL reconstructive surgery rehab is focused on achieving the following 12-week initial rehab goals:

Weeks 1 through 6:

  • Weight bearing in extension.
  • A home program for quadriceps strengthening is started

Week 2 through 6

  • Formal physical therapy begins, including passive and active-assist range of motion.

Week 6

  • Physical therapist begins more aggressive strengthening of the quadriceps and hamstrings, as well as hip and core muscles.

Week 12

  • Running and agility training is permitted, and a return to full athletics may be anticipated starting at 4 months.

DR. AHMAD’S EXPERIENCE

Dr. Ahmad is nationally recognized expert in patella instability surgery and has designed and studied the optimal methods to surgically correct patella instability. His undergraduate training in mechanical engineering has allowed him to research the optimal methods of treatment. Dr. Ahmad has performed several hundred patella instability surgeries and has treated all types of patients from elite professional athletes to recreational athletes who sustained patella dislocations.

Listed below is Dr. Ahmad’s scholarly articles and research published to help patellar instability treatment.

Dr. Ahmad’s Scholarly Publications Related to Patella Dislocations