MPFL (Medial Patellofemoral Ligament) Reconstruction is a surgical procedure designed to stabilize the kneecap (patella) after recurrent dislocations. The MPFL is a critical ligament that prevents the patella from slipping out of place. When this ligament is damaged or stretched due to injuries or genetic factors, the kneecap becomes unstable, leading to pain and mobility issues. This surgery involves reconstructing the ligament using a graft, often from the patient’s own tissue or a donor. It’s a common solution for those suffering from chronic patellar instability who haven’t found relief through physical therapy alone. The goal is to restore normal knee function and prevent future dislocations.
The MPFL is a thin but strong band of tissue located on the inner side of the knee, connecting the femur (thigh bone) to the patella (kneecap). It provides about 50-60% of the stability preventing lateral (outward) displacement of the kneecap. When the knee bends, the patella moves within a groove in the femur, and the MPFL ensures it stays aligned. Injuries to this ligament—whether from acute trauma or repetitive stress—can lead to instability, making the knee prone to dislocations. Understanding this anatomy helps patients appreciate why reconstruction is often necessary when conservative treatments fail to restore proper function.
MPFL Reconstruction is typically recommended for individuals who experience recurrent patellar dislocations—often two or more episodes—despite proper rehabilitation. Candidates may include athletes, young adults with loose ligaments, or those with structural abnormalities affecting kneecap alignment. People who continue to feel instability during daily activities (like climbing stairs or pivoting) or have persistent pain despite physical therapy are also potential candidates. The decision for surgery depends on factors like age, activity level, and the presence of additional knee damage. A thorough evaluation by an orthopedic surgeon helps determine if MPFL reconstruction is the right solution for long-term knee stability.
Before MPFL reconstruction, a detailed assessment is conducted to confirm the need for surgery. This includes a physical examination to check kneecap mobility, strength, and alignment. Imaging tests such as X-rays, MRI, or CT scans help evaluate the ligament’s condition, bone structure, and any associated damage (like cartilage injuries). Some patients may also undergo a dynamic ultrasound to observe patellar movement in real-time. These diagnostics ensure the surgeon tailors the procedure to the patient’s specific needs. Pre-surgical counseling covers risks, recovery expectations, and preoperative instructions (e.g., fasting, medication adjustments) to optimize outcomes.
MPFL Reconstruction is typically performed under general or regional anesthesia and takes about 1–2 hours. The surgeon makes small incisions around the knee to access the damaged ligament. A graft (often from the hamstring tendon or a donor) is secured to the patella and femur using screws or anchors, recreating the ligament’s stabilizing function. Advanced techniques may use arthroscopy for minimal invasiveness, reducing scarring and recovery time. The new ligament is tensioned carefully to avoid over-tightening, which could restrict motion. Post-surgery, the incisions are closed, and the knee is bandaged and braced for protection. Most patients go home the same day with detailed aftercare instructions.
Recovery from MPFL Reconstruction follows a phased approach. Weeks 1–2: Focus is on pain management, reducing swelling, and gentle range-of-motion exercises. Weeks 3–6: Gradual weight-bearing and strengthening begin, often with a brace for support. Months 2–4: Physical therapy intensifies to restore strength and proprioception (balance). Most patients resume light activities by 3 months, but full recovery—especially for athletes—can take 6–12 months. Adherence to rehab is crucial; skipping exercises may compromise stability. Regular follow-ups ensure the graft heals correctly. While individual timelines vary, patience and consistency are key to regaining knee function safely.
Though MPFL Reconstruction is generally safe, like all surgeries, it carries risks. These include infection, blood clots, or stiffness in the knee joint. Graft failure or over-tightening may lead to recurrent instability or restricted movement. Some patients experience numbness near incision sites due to minor nerve damage. Rarely, the kneecap may still dislocate post-surgery if rehabilitation is inadequate. Choosing an experienced surgeon minimizes these risks. Preoperative health optimization (e.g., quitting smoking) and strict adherence to post-op care instructions further reduce complications. Most issues are manageable with prompt medical attention, ensuring a smooth recovery.
MPFL Reconstruction boasts high success rates, with studies showing over 90% of patients achieving stable kneecaps and reduced dislocations. Long-term outcomes are excellent for those who complete rehabilitation; many return to sports or daily activities without limitations. Success depends on factors like surgical technique, graft quality, and patient compliance with rehab. Younger patients and those without severe arthritis typically fare best. While some may experience occasional stiffness or discomfort, most report significant improvements in pain and function. Regular exercise to maintain knee strength helps preserve results for decades, making this surgery a reliable solution for chronic instability.
1. How painful is MPFL Reconstruction surgery?
Pain is manageable with prescribed medications and typically subsides within a few days to weeks. Ice and elevation also help reduce discomfort and swelling early in recovery.
2. Will I need a knee brace after surgery?
Yes, a brace is usually worn for 4–6 weeks to protect the graft. Your surgeon will guide you on when to transition to a smaller support or discontinue use.
3. Can the MPFL graft fail?
Graft failure is rare (<5% of cases) but possible if the knee is re-injured prematurely. Following activity restrictions and rehab protocols minimizes this risk.
4. When can I return to sports?
Athletes often resume sports at 6–9 months post-op, after passing strength and stability tests. Early return increases re-injury risk.
5. Is physical therapy mandatory?
Absolutely. PT restores strength, flexibility, and balance. Skipping it may result in poor outcomes or recurrent instability.