Surgery is considered when it is the right choice for you. Before your operation you will receive a Preparing for Surgery booklet and a detailed guide related to your specific procedure.
Overview
The kneecap (patella) glides in a groove at the end of the thighbone. The medial patellofemoral ligament, or MPFL, is a band of tissue on the inner side of the knee that holds the kneecap in that groove. It is the main structure resisting the kneecap sliding outward and it may tear or become functionally incompetent when the kneecap dislocates. Once torn it usually heals loose or not at all which contributes to why the kneecap can keep coming out.
MPFL reconstruction replaces that torn ligament with a new one. A tendon graft is fixed to the edge of the kneecap and to the thighbone at the point the original ligament came from, recreating the checkrein that was lost.
- Stability is the main result and it is reliable.
- Most patients get back to sport but fewer get back to the same level. About 85 to 93% return to some sport. Around 68 to 71% return at their previous level.
Technique
- Done through two or three small incisions on the inner side of the knee. A camera is usually used first to look inside the joint and check the cartilage.
- A donor tendon (allograft) is used.
- The graft is attached to the inner edge of the kneecap with suture anchors.
- The other end is fixed at the spot where the ligament attaches to the thighbone (femur). This position is confirmed with an X-ray during surgery.
Torn MPFL (left) and MPFL reconstruction (right).
Image: HSS
Recovery
Getting Back to Activity
- Weeks 0-2Brace, partial weight bearing
- Weeks 3-6Off crutches, full motion
- Weeks 7-12Brace off, strengthening
- Months 3-4Running starts
- Month 4+Agility and sport drills
- Months 7-9Return to sport
Recovery Milestones
- School or desk work: About 1 to 2 weeks, on crutches.
- Off crutches: 3 to 6 weeks.
- Out of the brace: Around 7 weeks.
- Running: 3 to 4 months, in a straight line.
- Cutting and pivoting: Usually after 4 months.
- Return to sport: About 6 to 7 months on average.
Return to sport is based on strength, control and confidence rather than the date, and requires clearance.
For how this condition is diagnosed and every treatment option, including nonoperative care, read the full Patellar Instability guide.
Instructions and therapy protocols
Each version of this operation has its own post-op instructions and physical therapy protocol. Bring the protocol to your first therapy visit.
- MPFL ReconstructionPost-op instructionsPT protocol
- MPFL Reconstruction with Kneecap Cartilage Fragment FixationPost-op instructionsPT protocol
- Tibial Tubercle Osteotomy with MPFL ReconstructionPost-op instructionsPT protocol
