Category Archives for Ligament Instability

MPFL reconstruction

MPFL reconstruction is a reconstruction of the Medial Patellofemoral Ligament

What is an MPFL reconstruction?

By MPFL reconstruction surgery your injured inner ligament for the kneecap (MPFL) is replaced by a stronger ligament that keeps the patella (kneecap) in place. The ligament goes from the inner site of the patella and the quadriceps tendon towards the medial femoral condyle. The ligament is typically harvested from the back site of the thigh, by an incision over the inner site of the tibia.

Many surgeons say that you will just need an MPFL reconstruction and there is no reason do for example a trochleoplasty.

It can be right that MPFL reconstructions are very good in most situations. Nevertheless is the MPFL reconstruction just a new ligament and just like a shoelace, there is risk that it will not last more than a few years. This can be the case if there is trochlear dysplasia etc.

Is MPFL reconstructions always a good solution?

Unfortunately I see a number of patients who had MPFL reconstruction that re-rupture. I also see a number of patients who just have pain at the inner site of the knee, based on too strong forces on the ligament. Therefore make sure that you have an MRI scan and that your surgeon knows how to look for trochlear dysplasia and patella alta and increased TT-TG distance. Eventually read more here

New data indicate that the long term results are not as good as we had hoped. Check here 

This demonstrates how the new MPFL ligament looks like from the side.

Left is an example that demonstrates how an MPFL reconstruction can be performed - the picture shows how it looks just before inserting the screw that is going to secure the ligament until it has grown tight to the bone after a few months.

After the operation?

What are you allowed to do and what can you do after an MPFL reconstruction? Normally do I never prescript braces after an MPFL reconstruction. You are allowed full weight bearing and free range of movement. Already a few days after the surgery I recommend that you start to do physiotherapy guided exercises in order to regain strength and ability to bend your knee

Sick Leave after MPFL reconstruction?

For how are you going to stay away from school or work? This is a very good question, since there is huge individual variation. Some will be already back after a week, while for those have heavy physical work it may take 2-3 month. Another thing of importance is how you transport yourself from home to school or work 


When are you allowed to return to sport? This depends on what type of sport you participate. If  it is contact sport you have to wait until the muscles are finally back in force and balance, however you always need to wait at least 4 month..​

What safety level of activity is recommended after MPFL reconstruction?Normally I do not use any brace or limitation in range of movement and I allow full weight bearing. A few days after surgery physiotherapy-guided exercises are recommended.