What should you know about MPFL reconstruction with tibial tubercle osteotomy?

The MPFL helps resist outward movement of the kneecap. The tibial tubercle is the bony prominence where the patellar tendon attaches below the kneecap. During an osteotomy, the surgeon makes a controlled bone cut, moves that attachment to improve tracking or pressure, and secures it while it heals. Combining the procedures may address both soft-tissue instability and bony alignment. The operation is more involved than ligament reconstruction alone, so protection and bone healing influence the rehabilitation plan. Background on [Patellar Dislocation](/conditions/patellar-dislocation/) and [MPFL Reconstruction](/treatments/sports-and-arthroscopic-surgery/mpfl-reconstruction/) may help.

Expect specific limits for weight-bearing, brace use, and knee bending. Use crutches exactly as taught and keep dressings and incisions clean. Do not kneel, pivot, squat deeply, or increase walking because the knee feels better unless cleared. Physiotherapy may begin with swelling control and safe motion, then progress to thigh activation, walking mechanics, strength, balance, and daily function. Follow-up imaging or examination may be used to confirm bone healing before higher-impact activity.

Contact the surgical team for worsening incision redness, drainage, fever, increasing swelling, or pain that is escalating rather than settling. Seek urgent care for chest pain, sudden breathlessness, severe calf pain, or a cold, pale, or numb foot. Report a fall, a new deformity, a sudden kneecap shift, or inability to follow the prescribed weight-bearing plan.

Ask what alignment issue the osteotomy addresses, where the bone will be moved, what hardware will remain, how long weight-bearing is restricted, and what examination or imaging confirms healing. Clarify how the combined procedure changes driving, work, stairs, and sport plans.