What is MPFL reconstruction surgery?

The ligament being rebuilt

The medial patellofemoral ligament (MPFL) is a thin band that runs from the inner edge of the kneecap to the inner side of the thigh bone. It is the main soft-tissue restraint against the kneecap slipping outwards, especially in the first part of bending before the kneecap settles deep into its groove.

It is torn or stretched in almost every kneecap dislocation. In many people it heals adequately; in others it heals loose and the kneecap keeps slipping.

How the operation is done

• It is usually performed under general or spinal anaesthesia, often as a day case or with one night in hospital
• An arthroscopy (keyhole camera) is commonly done first to check and treat any cartilage damage
• A tendon graft is taken, most often one of the hamstring tendons from the same leg
• Through small incisions, the graft is fixed to the inner edge of the kneecap and to a precise point on the thigh bone, checked with X-ray during surgery
• The tension is set so that the kneecap is held securely but still moves freely

Who it suits

MPFL reconstruction is mainly recommended for people whose kneecap has dislocated more than once, or whose knee feels unstable enough to stop them from sport or daily activities despite good physiotherapy. When the kneecap sits very high or the tendon pulls strongly outwards, it may be combined with a bony realignment, and in growing teenagers the technique is adapted to protect the growth plates.

Discussing it in Doha

At Aman Hospital, Dr. Gelber explains whether MPFL reconstruction alone is likely to be enough for your knee, based on your examination and MRI measurements, and what the recovery would involve for your work, study or sport. You can bring previous scans and reports to the consultation.