From the Research
MPFL reconstruction is a surgical procedure to repair or rebuild the medial patellofemoral ligament, which is the primary soft tissue restraint preventing lateral displacement of the patella (kneecap), and is typically recommended for patients who experience recurrent patellar dislocations or instability that hasn't responded to conservative treatments. This surgery is effective because it recreates the anatomical restraint that prevents the patella from dislocating laterally, addressing the underlying biomechanical problem rather than just treating symptoms. The procedure involves creating a new ligament using either the patient's own tissue (autograft) or donor tissue (allograft), anchoring it to the femur and patella to restore normal tracking of the kneecap 1.
Key Points
- MPFL reconstruction is a surgical technique to restore patellofemoral stability after lateral patellar dislocation 2
- The procedure involves creating a new ligament using either autograft or allograft, anchoring it to the femur and patella 3
- Recovery typically involves wearing a knee brace for 4-6 weeks, followed by physical therapy for 3-6 months to restore strength and range of motion 4
- The rehabilitation protocol generally progresses from initial protection and gentle range of motion exercises to strengthening and eventually return to sports activities, usually around 6 months post-surgery 5
Recent Findings
A recent cadaveric biomechanical study found that an isolated MPFL reconstruction may not be sufficient to restore patellar stability in the setting of a shallow or flat trochlea, and that patients with an abnormal sulcus angle may have recurrent instability postoperatively if treated with an isolated MPFL reconstruction 1.
Clinical Implications
The most recent and highest quality study suggests that MPFL reconstruction is an effective procedure for treating recurrent patellar dislocations or instability, but may not be sufficient in cases with trochlear flattening. Therefore, careful patient selection and consideration of additional procedures to address trochlear abnormalities may be necessary to ensure optimal outcomes 1.