MPFL/MCL/LCL Injury Treatment

What are MPFL/MCL/LCL Injuries?

The knee is stabilized by several key ligaments that work together to provide proper movement and function. The Medial Patellofemoral Ligament (MPFL) connects the patella (kneecap) to the femur and prevents lateral displacement of the kneecap. The Medial Collateral Ligament (MCL) runs along the inner side of the knee and provides stability against forces that would push the knee inward. The Lateral Collateral Ligament (LCL) runs along the outer side of the knee and provides stability against forces that would push the knee outward. Injuries to these ligaments can occur from direct impact, sudden twisting motions, or from chronic overuse, affecting the knee's stability and function.

Common Symptoms of Ligament Injuries

• MPFL Injury: Kneecap instability or dislocation, pain around or behind the kneecap, swelling, difficulty with stairs, and a feeling that the knee is giving way
• MCL Injury: Pain along the inner side of the knee, swelling, stiffness, instability when changing direction, and bruising
• LCL Injury: Pain along the outer side of the knee, swelling, knee instability particularly when bearing weight, and difficulty walking
• General Symptoms: Popping sound at the time of injury, immediate pain, inability to continue activity, joint stiffness, and decreased range of motion

Advanced Diagnostic Approaches

Dr. Abhishek Saxena employs a multimodal diagnostic approach to accurately assess ligament injuries. This includes:

• Specialized physical examination with stress testing to evaluate ligament integrity
• High-resolution MRI to visualize ligament tears, associated injuries, and to grade severity
• Stress radiographs to quantify joint instability
• Dynamic ultrasound assessment for real-time evaluation of joint movement
• Diagnostic arthroscopy for complex cases or when multiple injuries are suspected

Treatment Options

Treatment for ligament injuries varies based on the specific ligament involved, injury severity, and patient factors. Our comprehensive approach includes:

• Conservative Management: For Grade I and some Grade II injuries, including RICE protocol (Rest, Ice, Compression, Elevation), bracing, and structured physical therapy
• MPFL Reconstruction: Advanced arthroscopic and mini-open techniques using autograft or allograft tissue to restore patellofemoral stability
• MCL Repair/Reconstruction: Direct repair for acute injuries with good tissue quality or reconstruction using hamstring grafts for chronic or severe cases
• LCL Reconstruction: Anatomic reconstruction techniques to restore lateral knee stability while addressing any associated posterolateral corner injuries
• Biological Augmentation: Platelet-rich plasma (PRP) and other growth factors to enhance healing for partial tears
• Combined Ligament Procedures: Addressing multiple ligament injuries with staged or simultaneous surgical approaches

Cutting-Edge Surgical Techniques

Dr. Saxena specializes in the latest minimally invasive and anatomic reconstruction techniques for ligament injuries:

• Anatomic MPFL reconstruction with precise graft positioning and tensioning
• Internal bracing techniques for MCL injuries to allow early mobilization
• Arthroscopic-assisted LCL and posterolateral corner reconstruction
• Individualized graft selection based on patient activity level and anatomy
• Computer-navigated ligament reconstruction for complex cases

Rehabilitation and Recovery

Recovery from ligament injuries requires careful rehabilitation to restore stability, strength, and function. Our personalized rehabilitation protocols include:

• Early protected range of motion to prevent stiffness while protecting the repair
• Progressive weight-bearing based on healing milestones
• Neuromuscular training to restore proprioception and dynamic stability
• Targeted strengthening of supporting muscle groups
• Sport-specific training for athletes returning to competition
• Functional testing before clearance for return to sports or high-demand activities

Most patients can expect a return to daily activities within 6-12 weeks following surgery, with return to sports typically occurring between 6-9 months, depending on the specific ligament involved and the nature of the sport or activity.

Prevention Strategies

Dr. Saxena emphasizes injury prevention as part of comprehensive care. Recommendations include:

• Neuromuscular training programs that focus on proper landing mechanics
• Core and lower extremity strengthening exercises
• Proper warm-up protocols before athletic activities
• Sport-specific conditioning to prepare for the demands of particular activities
• Appropriate footwear and bracing for high-risk activities or previous injuries