NOTES - Surgical Procedures :

Reconstruction of medial patello-femoral ligament - - Posted by trinwin (trinwin), 22 December 2003

Although not immediately, I am due to have this op as a result of dislocating my patella 30 years ago!  Arthritis has now set in as a result so the OS feels that this will be of benefit to me.  Has anybody had this op?  Any advice?  Thanks all!
Posted by anasta5ia (anasta5ia), 26 December 2003

Trinwin-
I have had both a MPFL repair and MPFL reconstruction on my right knee.  I'm going to be having it done on the left within the next 8 weeks or so.

There are several ways in which this ligament can be reconstructed.  If you IM me with your questions I will give you the best answers that I can.

-Heather G.
Posted by trinwin (trinwin), 26 December 2003

Hi Heather - thanks for your reply.  So you have had this done - trust all went well for you.   Basically I want to know how good the results are and how long it takes to get back to 'normal' (whatever that is!)  By putting my patella back in place, it makes sense that this will stop the maltracking problems .. can it make the arthritis better?

Hope you had a good Christmas.  Many thanks.  
Posted by Kimby (Kimby), 3 January 2004

Trinwin - had this procedure done also in conjunction with my TTT.  They can do this one of two ways - take a ligament from your thigh and use that, or use one from a cadavor.  I opted for the cadavor because I was also having the TTT done and 3 surgeries might have been over the top.  

I had some pain for quite a while with the new ligament.  It's very stiff and hard - you have to massage it regularly (I used vitamin E capsules - broke them open and massaged with the oil - it helps with the scars, too).  But, the upside is that in conjunction with the TTT my knee no longer pops, clicks, grinds or dislocates.  It's worked out real real well.  Getting the other knee done sometime this year.

Good luck!  IM me if you have any other questions.  

Kim

Posted by anasta5ia (anasta5ia), 6 January 2004

Trinwin-
Sorry it has taken me so long to get back to you.  I just had my tonsils removed and have been having a rough go of it.

As Kimby said, you can have either an allograft using a piece of a tendon from yourself, or have a cadaver ligament/tendon used.  Hoverever, in my surgery, I had material used called SIS (small intestinal submucosa).  If you search using that, I had posted some stuff about it a while back.  In using this, they completely removed my existing tissue and replaced it with this.  Your body then actually comverts this to ligament tissue instead of scar tissue as with the other methods.

We chose to use the SIS as I had a failed repair of the MPFL and we were pretty sure that with the severe lateral pull on my patella that this would be the only material strong enough to hold it in place.

I also have had 3 TTT's on the right knee as my patella was so malaligned that it was useless to do the reconstruction without correcting the other main source of the dislocation.  

My OS and I are keeping our fingers crossed, but so far, so good.  I have had severe retrictions with aspect to the rehab and stuff and even now at 10 weeks post-op I am still not completely weightbearing.

If you need anything else, let me know.

Hugs-
Heather G.
Posted by Kimby (Kimby), 6 January 2004

Interestingly enough, I just got back from my OS's office.  He says that when you do the TTT that to not also do the ligament reconstruction is a crying shame because though the bone isn't necessarily aligned properly, he says a good portion of the source of the dislocation is the ligament and/or tendon too.  He said he has to redo a lot of TTTs that are done by people who don't also do the ligaments or tendons (depending on the direction of the dislocation).

FYI -

Thanks!

Kim
Posted by bdmrad (bdmrad), 15 January 2004

I had it done almost three months ago. This was my first and hopefully only knee surgery. I had been dislocating fot 35 years but did not have pain, but ultimately developed maltracking such that I had to wear a Breg PTO to function.  I am just getting to the point of not limping and still have considerable quad weakness, but I hope to snowboard in March.

I think it is logical to reconstruct the MPFL if you are dislocating or if you think that maltracking is contributing to the pain.  You might want to consider a trial of the Breg Patellar tracking Orthosis. If this relieves your pain, then you might suppose that MPFL reconstruction may help.  Good luck.
Posted by boputnam (boputnam), 27 January 2004

on 01/15/04 at 01:39:45, bdmrad wrote:

Hey, bdmrad...

Thanks for the reply.  Sadly, I share your condition - both.  However, I have an added complication relating to a R hip dislocation (1974) that has affected my gait, and posture.  My R leg is shortened about 2cm +/-.  This causes my pelvis to rotate L when standing on the R leg, seemingly increasing the Q angle and exacerbating the lateral dislocation geometry. Uniquely, my dislocations have all been to my R patella (L has been quiet...).  Now, being better informed through my research I understand my unique vulnerability -  Ugh...

Could you please provide references to some of the research you found most relevant?  I've got quite a few articles from Elseviere @ www.sciencedirect.com (e.g., Amis, Smirk, Nomura, etc.), and have seen referrals to Insall, but have nothing in-hand.  

Thanks, in-advance.  Email me your shipping address, and I'll gladly forward a bottle of fine red wine for the troubles..  

This old Forum was so valuable that we have kept it as an archive. It is just for reference. If you want to ask questions or offer advice, there is also a current Bulletin Board which you can access from our home page.

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