Is MPFL Reconstruction Surgery Necessary for Me?
At 21 years old, I experienced a dislocated kneecap in February 2025, and subsequent MRI results revealed a complete tear of my medial patellofemoral ligament (MPFL). Following this injury, my orthopedic specialist advised strict bed rest for a month and a half, after which I began physical therapy. Initially, I struggled even to bend my knee. My therapist assured me that surgery would not be necessary, promising that my condition could be managed solely through rehabilitation. After two months of therapy, I had regained some ability to bend my knee, yet a sharp, pinching pain remained when squatting, particularly in the upper range of motion. When I inquired about this persistent pain during our sessions, I often received unsatisfactory and vague responses. Feeling frustrated and suspicious about the therapy's efficacy—especially considering the daily fee of 500 rupees—I decided to discontinue. Being a powerlifter, my primary goal is to return to lifting weights. To achieve this, I enlisted a powerlifting coach with knowledge of rehabilitation. I have been training with him for the past two months and have started to lift weights closer to what I used to handle, although the pain is still present, albeit less intense. He advised me that in rehabilitation, it’s not about completely eliminating pain but rather learning to train with it. Nonetheless, exercises like leg extensions remain particularly challenging for me. While the discomfort has decreased during gym workouts such as squats and deadlifts, my love for football and basketball complicates things. Whenever I perform explosive maneuvers with my left leg, the resulting pain in my knee can reach a level of 10 out of 10. Essentially, I find it difficult to execute any dynamic, explosive movements. Given my circumstances, do I require surgery to achieve a state free of pain? What steps should I take next? I find myself nearing the end of my rehabilitation, and my finances are quite strained, making it tough to consult doctors or seek further rehabilitation services.
Answers (1)
9/3/2025, 10:40:46 PM
OpenHealth AI
Based on your situation, surgery may not be immediately necessary, but further assessment of your knee's condition and your goals is important. Here's a breakdown of your current status and actionable next steps.
Main Points:
- MPFL tears can often heal with rehabilitation but may require surgery if pain persists or function is limited.
- Your symptoms during high-impact activities indicate that your knee might not be ready for explosive movements.
- Focusing on targeted rehabilitation and possibly modifying your activities may improve your condition.
Explanation:
You sustained a significant injury, and while many complete MPFL tears do improve with conservative treatment like physical therapy and rehabilitation, persistent pain during dynamic activities can suggest that more intervention may be needed. Your discomfort, especially when performing explosive actions in sports, points to potential instability or a need for further strengthening and stability of the knee.
Next Steps:
-
Pain Management and Activity Modification:
- While you’re committed to returning to powerlifting, consider reducing or modifying high-impact activities like football and basketball until your knee is stronger and pain-free.
- Opt for low-impact exercises and consider including isometric strength training, which can help build muscle without putting too much strain on your knee.
-
Targeted Rehabilitation:
- Continue working on your rehab but focus on specific exercises that improve knee stability, like balance work and strength training for the quadriceps, hamstrings, and hip muscles.
- Using resistance bands can be helpful for controlled movements that strengthen the knee without excessive strain.
-
Monitoring Pain and Function:
- Keep track of your pain levels with different activities. If you reach a point where these levels consistently remain high (7-10 out of 10) during low-impact exercises or basic movements, this should prompt a reevaluation of your rehabilitation approach.
- If pain is consistently present during activities of daily living or continues to escalate, this could indicate that further medical evaluation is needed.
-
Explore Cost-Effective Consultation Options:
- Look into community health centers or sports clinics that offer sliding scale fees or group therapy sessions. Sometimes, universities with physical therapy programs offer services at lower costs as students gain experience under supervision.
-
Consider Seeking a Second Opinion:
- If possible, seek a second opinion about your injury and potential surgical options. A different perspective might provide new insights into your condition and rehabilitation approach.
Remember, the goal is to manage your condition effectively while preserving your ability to perform the activities you love. Prioritize your safety and long-term health over immediate performance goals. If you have more questions or need further clarification as you progress, feel free to reach out!
Related Questions
Unexplained Bruising and Intense Itching
Hello, I’m a 20-year-old female, standing at 5 feet 2 inches and weighing 135 pounds. Recently, I have been experiencing intense itching that has resulted in significant bruising on my skin. Currently, I’m on several medications including spironolactone (which I haven’t taken for the last two weeks), Effexor, Aimovig, Wegovy, and Linzess. I do not use tobacco or consume alcohol. Apart from experiencing a generally sluggish digestive system, I have no pre-existing health issues. However, my family medical history indicates occurrences of Multiple Sclerosis, Hashimoto’s disease, diabetes, and eczema. The itching has become severe, leading to large bruises forming on my body. I consulted a virtual urgent care service, which advised me to visit the emergency room to check for potential blood clots or internal bleeding. Upon arriving at the ER, I underwent various tests, and I noticed that my resting heart rate has been notably elevated between 120 and 140 beats per minute, though I am uncertain if this is a new development. Eventually, I was discharged without any conclusive information, except with the advice to refrain from scratching. I have shared images of the tests conducted during my visit.
Understanding Prednisone Usage and Withdrawal
A 38-year-old woman, measuring 5’10 and weighing 125 pounds, with no smoking or drinking habits and a background of autoimmune disease, encountered a viral infection in December. In response to her condition, a specialist recommended a tapering regimen starting with a 40mg dose of prednisone for five days, followed by a gradual reduction through 30mg, 20mg, and 10mg over a total period of 20 days. After completing the course and halting the medication, she experienced severe symptoms approximately 36 hours later, including intense vomiting, debilitating headaches, and widespread pain throughout her body. Any physical contact provoked discomfort, leaving her in distress. Unable to reach her original provider, she consulted another physician who prescribed a lower dosage of 4mg of prednisone, instructing her to decrease the amount by 1mg every three days. Remarkably, she felt relief upon returning to the 4mg dose. However, she expressed concern regarding the potential effects when she ultimately weans off the medication entirely. She is seeking guidance on whether this method of tapering is typical and which specialist might be best suited to manage her prednisone treatment moving forward.
Recurring Mysterious Rash Every Year, All Tests Negative
Hello everyone! I'm an 18-year-old female, and I don't consume alcohol, smoke, or engage in any recreational drug use. Around the middle of January last year, I noticed a gradual appearance of a rash across my body that escalated into a severe illness after approximately a week and a half of its onset. Currently, I find myself in a similar situation, suggesting that this might be a yearly recurring issue. At the moment, the rash isn't itchy, although I've recently had a mild sore throat. Thankfully, I don't have any other signs of illness right now. Last year, when I was unwell, it was an incredibly challenging experience; I felt extremely weak, had a runny nose, persistent cough, sore throat, and even experienced moments of confusion due to fever. The rash did become itchy once I fell ill. During last year's episode, I sought medical advice and underwent several tests while dealing with the rash. All results came back negative, including tests for mononucleosis. The only positive result was for a common cold. Having received vaccinations for measles, mumps, and rubella during my childhood (despite having had those diseases), I'm fairly certain this isn't related to any of them, and I believe I tested negative for those as well last year. Any insights or advice would be greatly appreciated! Thank you from a financially struggling college student!
Concerns About Abdominal Distension
Hello, I'm a 25-year-old female, weighing approximately 51 kilograms and standing at 155 centimeters tall. I have established allergies to Prospan and certain vitamins, which I actively avoid in my diet. My daily caloric intake is around 2250 kcal, and I supplement my nutrition with B complex vitamins, omega-3 fatty acids, and vitamins C and D. I do not have any identified food allergies that I know of. I maintain a workout regimen that spans four days each week, followed by a day of rest. However, I’ve noticed a consistent issue where my lower abdomen noticeably swells after each meal. To me, it resembles the growth associated with early to mid-pregnancy, and it seems to occur only in that specific area. This situation is worrying me, and I would greatly appreciate any advice you might be able to provide. I am contemplating visiting a gastroenterologist soon, but I thought I’d ask for perspectives here as well, just in case. Thank you for any insights you can share. Best, 'Not Pregnant, Just Full' girl
Persistent Swelling in Armpits for Over a Decade Without Discomfort
Hello everyone! I’ve been dealing with persistent swelling in my armpits for over ten years now. The swelling is more pronounced on the right side compared to the left. Interestingly, there is no pain associated with it, and both areas are soft to the touch. I don’t have any other health conditions that could be linked to this issue. Does anyone have insights on what might be causing this?