What is the MPFL, and Why is it Important for Knee Function?

The Medial Patellofemoral Ligament (MPFL) is a band of tissue on the inner side of the knee that helps keep your kneecap (patella) stable and properly aligned, especially during movement like bending, squatting, or running.

When the MPFL is torn—typically from a kneecap dislocation or traumatic injury—it can lead to repeated dislocations, instability, pain, and a loss of confidence in movement. Without a properly functioning MPFL, the kneecap can drift out of place, damaging cartilage and increasing the risk of arthritis over time.

How is MPFL Reconstruction Performed?

MPFL reconstruction is a minimally invasive outpatient procedure designed to restore stability to your kneecap. The torn ligament is replaced with a new graft—often using a small piece of your own tendon (usually the hamstring) or a donor graft (allograft).

Step-by-Step Overview:

1. Arthroscopic Assessment – The surgeon first inspects the knee joint using a small camera (arthroscope).

2. Graft Harvest – If an autograft is used, a small portion of your own hamstring tendon is carefully taken.

3. Precise Tunnel Creation – Small bone tunnels are made in the femur and patella to anchor the new ligament.

4. Graft Placement and Fixation – The graft is secured using advanced fixation devices like bioabsorbable screws or anchors.

5. Tensioning and Alignment – The new ligament is tensioned carefully to ensure the patella tracks normally through a full range of motion.

   
   

Advanced Techniques and Technologies in MPFL Reconstruction

Modern MPFL reconstruction focuses on anatomic precision, graft stability, and minimizing complications. Here’s what sets today’s approach apart:

• Anatomic Tunnel Placement with 3D Imaging or Fluoroscopy
  Advanced imaging tools allow surgeons to place grafts exactly where the native MPFL attached, reducing the risk of stiffness or overcorrection.

• All-Inside Technique
  Some surgeons use an "all-inside" method, minimizing bone drilling and reducing surgical trauma—ideal for young, active patients.

• Knotless Anchor Systems
  These low-profile implants allow for strong graft fixation without bulky knots or screws, improving comfort and recovery outcomes.

• Hybrid Grafts
  In certain cases, biocompatible synthetic augmentation may be used alongside biological tissue for added strength during early recovery, especially in high-risk athletes.

• Combined Realignment Procedures
  If your anatomy places you at risk for repeat dislocations (e.g., high-riding kneecap or knock knees), MPFL reconstruction may be combined with tibial tubercle osteotomy (TTO) or other alignment corrections.

Imani McGee-Stafford – WNBA

• The professional basketball player underwent MPFL reconstruction after suffering repeated patellar dislocations during her career.

Following surgery and rehab, she returned to compete in the WNBA, showing that elite-level performance is possible after this procedure.

Kelsey Robinson – Olympic Volleyball Player

• Robinson, a member of the U.S. Women’s National Volleyball Team and Olympic medalist, had MPFL reconstruction surgery due to chronic kneecap instability.

• She made a successful return to international competition and helped lead Team USA to medal-winning performances.

Travis Frederick – NFL (Dallas Cowboys)

• Although better known for other injuries, Frederick sustained kneecap instability early in his career and underwent MPFL reconstruction.

• He returned to the NFL and went on to become a Pro Bowl center, showing that linemen, in particular, can achieve full strength post-surgery.