What is MPFL?

The MPFL (Medial Patellofemoral Ligament) is a crucial ligament in the knee joint that plays a significant role in stabilizing the patella (kneecap). It connects the medial (inner) side of the patella to the femur (thigh bone) and helps to prevent lateral (sideways) displacement of the patella during knee movement. MPFL injuries are relatively common, especially in activities that involve sudden changes in direction or direct trauma to the knee.

There are three grades of MPFL injuries:

  1. Grade I: This is a mild injury where the ligament is stretched but not torn. The knee joint remains stable, and there is minimal swelling and pain.

  2. Grade II: In this type of injury, the MPFL is partially torn. The knee joint may feel unstable, and there is usually more swelling and pain compared to a grade I injury.

  3. Grade III: This is the most severe type of MPFL injury where the ligament is completely torn. The patella is highly unstable, and there may be significant swelling, pain, and difficulty bearing weight on the affected leg.

 

Menifestation of MPFL Injury

Causes of MPFL injuries include:

  1. Direct impact or trauma to the knee: Such as a fall or a blow to the kneecap, often seen in contact sports or accidents.

  2. Non-contact injuries: These can occur during sudden changes in direction or deceleration, putting excessive stress on the ligament.

  3. Pre-existing factors: Some individuals may have anatomical abnormalities or predisposing factors, such as a shallow groove in the femur, patella alta (high-riding kneecap), or ligament laxity, making them more susceptible to MPFL injuries.

Symptoms of an MPFL injury may include:

  • Swelling and bruising around the knee
  • Pain, especially on the inner side of the knee
  • Instability or feeling that the kneecap is shifting or “giving way”
  • Limited range of motion in the knee
  • Difficulty walking or bearing weight on the affected leg

Management of MPFL Injury

Diagnosis of an MPFL injury involves a thorough physical examination by a healthcare professional, including an assessment of knee stability and range of motion. Imaging studies such as X-rays, MRI (Magnetic Resonance Imaging), or ultrasound may be used to confirm the diagnosis and assess the severity of the injury.

Treatment options for MPFL injuries depend on the severity of the injury and may include:

  1. Conservative management: Rest, ice, compression, and elevation (RICE), along with physical therapy to strengthen the surrounding muscles and improve knee stability.

  2. Immobilization: In some cases, a brace or knee immobilizer may be used to protect the knee during the healing process.

  3. Medications: Pain relievers and anti-inflammatory drugs may be prescribed to manage pain and swelling.

  4. Surgical intervention: For severe MPFL injuries or cases of recurrent patellar instability, surgery may be recommended. Surgical options include MPFL reconstruction, where the torn ligament is repaired or replaced using tissue grafts, often from the patient’s hamstring or patellar tendon.