MPFL Reconstruction: What to Expect

MPFL reconstruction rebuilds a key ligament on the inner knee to help keep the kneecap aligned during movement.

Recovery is rehabilitation-led. Early care may include a brace, crutches, swelling control, and exercises that restore safe knee movement and thigh muscle activation. Weight-bearing and brace settings progress according to the reconstruction and examination. Later work develops strength, balance, landing control, and confidence. Returning to cutting or pivoting sport requires sport-specific testing rather than time alone.

A personal risk frequency cannot be predicted without knowing your anatomy, health, and surgical plan. Possible complications include infection, bleeding, blood clots, graft stretching or failure, stiffness, persistent pain, kneecap maltracking, or irritation from fixation material. Rehabilitation that advances too quickly or too slowly can also affect progress, so report swelling, locking, or loss of motion early.

The reconstruction is designed to improve kneecap stability, but it cannot guarantee that every pain or movement concern will disappear. The result depends on the cause of instability, graft position, muscle control, cartilage condition, and rehabilitation. The reconstructed ligament can be injured again, particularly with an early return to pivoting activity. Long-term strength and movement habits remain part of protection.

MPFL reconstruction addresses soft-tissue support on the inner side of the knee. It is different from simply treating pain because the central concern is kneecap tracking and stability. A brace and staged exercise plan are common parts of recovery. The surgeon may combine the reconstruction with another procedure when bone alignment or cartilage contributes to repeated dislocation.

A knee specialist may consider reconstruction after repeated kneecap instability or a dislocation when examination and imaging show that the MPFL is insufficient. The decision also considers alignment, bone shape, cartilage injury, activity goals, and previous treatment. Not every first episode needs reconstruction. A careful assessment of the Patellar Dislocation and its contributing factors guides the discussion.

After anaesthesia, the surgeon assesses the knee and prepares a tendon graft, which may come from your own tissue or a donor source. Small incisions are used to create secure attachment points on the kneecap and thigh bone. The graft is tensioned with the knee in a controlled position, then fixed. The incisions are closed and the brace and exercise plan are explained.

The first phase protects the graft while swelling and pain are managed. Exercises then focus on knee motion and quadriceps control, followed by progressive resistance, balance, and single-leg tasks. Running and jumping come later, after strength and movement quality have improved. Your clinician decides when sport drills and competition are appropriate based on function, not a calendar promise.

Possible problems include infection, blood clots, stiffness, persistent front-of-knee pain, altered kneecap tracking, graft failure, or continued instability. Contact the care team for fever, wound drainage, rapidly increasing swelling, calf pain, a cold or discoloured foot, or sudden loss of knee movement. Early review can identify problems before they interfere with rehabilitation.

Some people are managed with a brace, activity modification, strength training, movement retraining, and Physiotherapy after a kneecap instability episode. Further imaging may identify cartilage injury or alignment concerns that change the treatment plan. The choice between rehabilitation and surgery depends on recurrence, structural findings, symptoms, and the demands of work or sport.

Seek an orthopaedic knee specialist who evaluates kneecap alignment, ligament stability, cartilage, and lower-limb movement together. Ask which graft is proposed, whether another procedure is needed, how the brace and weight-bearing plan work, and what functional tests guide return to sport. Share your history of giving-way episodes and your activity goals.