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:
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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.
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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.
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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.
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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.
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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!
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