MPFL Reconstruction

I have officially set the date for my knee surgery-October 12th at Children's Hospital of Boston. Originally I had planned on waiting until December (after finals) to have the surgery. Because I am no longer taking classes this semester I see no point in waiting until December. I might as well get the surgery over with so that I can focus on recovery and actually make progress on my hip therapy. I also still need to have my right hip fixed and plan on having the PAO/scope in January or February.

I mentioned in an earlier post that I will be having an MPFL reconstruction and lateral release of my left knee. I have been experiencing frequent subluxations of my patella (sometimes while wearing the brace). I had an MRI which showed that my patella does not sit in the groove correctly and is subluxed laterally (outside of knee). I had an ultrasound which revealed a tear to the medial patellofemoral ligament (MPFL). Due to the laxity of EDS I need to have the ligament reconstructed. The surgery can be done several ways. With most patients a tendon from the hamstring is used to reconstruct. However, given EDS this is not an option for me. Using my own tendon would do absolutely nothing. Instead a cadaver tendon will be used. My surgeon also mentioned an osteotomy (Tibial Tubercle Transfer) to realign the tibial tubercle. However, my understanding is that we will hold off on the osteotomy for now. If the MPFL/lateral release procedure does not provide enough stability and I continue to have subluxations then the osteotomy will be our next option. However, during surgery if he feels I would benefit from the osteotomy (meaning there is more damage then expected) then I believe that will be performed as well. This is something I will definitely ask at my pre-op appointment as I'd like to be somewhat prepared if I wake up with a 5-6 inch scar down the middle of my knee. This surgery is an inpatient procedure and I will spend 1-2 nights in the hospital. My surgeon has also asked for another surgeon to be in on the surgery-although I am not sure why at this point.

Rehab for this surgery will depend on what procedures are performed. If the osteotomy is NOT performed then I should expect a 3-4 month recovery. I will be able to start formal therapy at 1-2 weeks post-op--and will be permitted to weight-bear as tolerated. However, if the osteotomy is performed then the recovery is 6-8 months and I will not start therapy until 6-8 weeks post-op (when the bones have healed).