Strategies for Reconstruction of the Medial Patellofemoral Ligament

The medial patellofemoral ligament (MPFL) has been identified as the main soft tissue restraint to lateral displacement of the patella. It is almost always injured with a patella dislocation, and as such, repair or reconstruction of the MPFL has become a common surgical procedure when treating recurrent patellofemoral instability. This article describes 3 techniques of MPFL reconstruction, with variations based on the method of fixation of the graft to the patella. Meticulous surgical techniques to try to avoid complications and an understanding of when to address some of the predisposing biomechanical factors causing patellofemoral instability should lead to good postoperative function and patient satisfaction.