Medial Patellofemoral Ligament (MPFL) reconstruction is a surgical procedure performed to stabilize the kneecap, or patella, particularly after dislocations. This surgery helps to restore the function of the MPFL, a ligament that connects the kneecap to the thigh bone and prevents it from moving outward. The procedure involves replacing the damaged ligament with a new piece of tissue, often a graft from the patient’s own hamstring tendon or a donor tendon. This article discusses the appearance, healing, and long-term look of MPFL reconstruction scars.
Where Surgical Scars Appear
MPFL reconstruction typically involves two or three small incisions around the knee. One incision is often located near the kneecap, while one or two others are usually found lower down on the inner side of the knee. The exact number and placement of these incisions can vary slightly depending on the specific surgical technique employed.
Immediately following the procedure, these incisions will appear as linear marks, typically 2-6 cm in length. They will be closed with sutures or staples, which are usually removed at a follow-up appointment, often around two weeks post-surgery. The area around the incisions will likely exhibit initial redness, swelling, and possibly some bruising, which is a normal response to the surgical trauma.
The Natural Scar Healing Process
The healing of surgical scars, including those from MPFL reconstruction, progresses through several distinct phases. Initially, the inflammatory phase begins immediately after surgery, characterized by redness, swelling, and tenderness around the incision sites. During this time, it is common to experience pain and limited movement in the knee.
Following the initial inflammation, the proliferative phase commences, where new tissue is formed. Collagen fibers are produced to bridge the wound, causing the scar to become firmer and potentially raised. This phase can last for several weeks to months.
The final stage is the remodeling phase, which can extend for many months, often up to a year or even longer. During this prolonged period, the collagen fibers reorganize, leading to the scar flattening, lightening in color, and softening in texture. Individual healing varies significantly due to factors such as genetics, age, and overall health.
Enhancing Scar Appearance
Improving the cosmetic appearance of MPFL reconstruction scars involves consistent care methods. Scar massage is a beneficial technique that can be started around two weeks after surgery, once the incisions have fully closed and any sutures or staples are removed. Gently massaging the scar for 1-2 minutes, 1-3 times per day, can help to loosen soft tissue, increase circulation, and reduce the firmness and tightness of the scar. Perform this on clean, dry skin, avoiding lotions or oils beforehand to prevent blistering.
Silicone products, available as sheets or gels, are recommended for scar management. These products create a protective barrier that hydrates the scar tissue, helping prevent excessive collagen production that can lead to raised scars. Silicone sheets are applied directly to the scar, often worn for 12-24 hours a day for several months, while gels are applied and allowed to dry. Consistent use for 8 to 12 weeks can significantly flatten and fade scars.
Sun protection is an important aspect of scar care. New and healing scars are particularly susceptible to UV radiation, which can cause hyperpigmentation, making the scar darker and more noticeable. Applying a broad-spectrum sunscreen with an SPF of 30 or higher to the scar, or covering it with UV-protective clothing, is advised for at least 3-6 months after surgery, especially when outdoors. Keeping the scar moisturized with gentle, unscented lotions after the initial healing period can help maintain skin elasticity and contribute to a smoother appearance. For problematic scars, advanced treatments like steroid injections or laser therapy exist, requiring consultation with a medical professional.
Long-Term Scar Expectations
Years after MPFL reconstruction surgery, individuals can expect their scars to fade significantly and become less noticeable. While scars are permanent marks of the healing process, they soften, flatten, and lighten in color over time, often blending more effectively with the surrounding skin. The initial redness and raised texture commonly seen in the first few months will diminish considerably.
It is important to understand that complete disappearance of a scar is rare. However, a well-healed scar can be subtle and integrate well with the surrounding skin tone and texture. Individual variability plays a role in the final outcome, with factors such as skin type, genetics, and adherence to post-operative scar care guidelines influencing how the scar ultimately appears. Even years later, the scar may remain a slightly different color or texture than the untouched skin, but its visibility reduces considerably.