How effective is MPFL reconstruction for patellar dislocation?

The medial patellofemoral ligament, or MPFL, helps keep the kneecap centred in its groove when the knee bends and straightens. A dislocation can stretch or tear this restraint. Reconstruction creates a new ligament-like graft and positions it to guide the kneecap, with the aim of reducing further slipping and improving confidence in the knee.

The operation is more likely to help when the main problem is a damaged or insufficient MPFL and the rest of the knee is assessed carefully. A shallow kneecap groove, altered leg alignment, a high-riding kneecap, cartilage injury or significant bone displacement may need a different or additional procedure. Surgery does not instantly restore strength: swelling, stiffness, quadriceps weakness and fear of movement can continue during rehabilitation.

Before surgery, ask how your imaging and examination identify the source of instability, whether cartilage or bone damage is present, and whether MPFL reconstruction alone addresses it. After surgery, follow the surgeon's limits on weight-bearing, brace use and knee movement. Physiotherapy usually progresses from swelling control and gentle motion to quadriceps activation, balance, strength and activity-specific drills. Returning to running, pivoting or contact sport should be based on movement control and strength as well as elapsed healing time.

Contact the surgical team promptly for increasing wound redness, drainage, fever, worsening pain or new calf swelling. Seek urgent care for chest pain, sudden shortness of breath, a cold or pale foot, or a knee that becomes acutely deformed. During recovery, a new giving-way episode, a locked knee or a sudden loss of movement needs assessment rather than pushing through exercises.

Ask: What is causing my kneecap instability? Is the MPFL the only structure that needs treatment? Is there cartilage damage to address? What restrictions will apply at each rehabilitation stage? Which signs would mean that my progress needs an earlier review?