Orthopaedics – Surgeries – Treatment
Treatment of Knee Diseases
Medial Patellofemoral Ligament (MPFL) Surgery
Chronic Instability or Hyperextension of the Patella
The patella naturally rolls in a groove of the femur (orbit) during knee flexion and extension, ensuring smooth movement of the joint. However, when stabilising factors such as ligaments, muscles or bone morphology are disrupted, a dislocation can occur, where the patella comes out of its groove, usually outwards.
Causes and Symptoms
Chronic patellar instability can result from rotational deviations of the knee, knee valgus or anatomical abnormalities. Repeated dislocations weaken the ligaments, making the patella increasingly unstable. Patients experience pain in the front of the knee, swelling, weakness of support, stiffness and in severe cases, joint deformity or early osteoarthritis.
Rehabilitation with Dynamic or Static Technique
The repair of the medial catheter ligament, with a hip or semi-tendinous autograft, is the most modern method of treatment. The techniques allow for smooth rolling of the patella on the orbit during knee flexion and extension.
The procedure includes:
- Detachment of the hip or semitendinous tendon.
- Creation of a tunnel on the medial side of the patella and fixation of the tendon at 1/3 of the patella.
- Creating a tunnel in the femur or using the natural tension of the adductor muscle during flexion, without excessive pressure.
Postoperative Rehabilitation
The procedure has excellent results in experienced hands, although it can cause increased pain in the first 2-3 days, which is effectively treated with anaesthetic nerve block. Over time, the technique provides excellent stability and restoration of patella function.
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