How I Reconstruct the MPFL (Medial Patellofemoral Ligament)

How I Reconstruct the MPFL (Medial Patellofemoral Ligament)

In this video, I walk you through medial patellofemoral ligament (MPFL) reconstruction — a procedure I perform for recurrent kneecap (patella) dislocation.

Harvesting the graft

I start by harvesting one of your hamstring tendons, securing it with sutures before it's fully released.

It's very rare that the MPFL is torn together with the ACL in the same knee. When that happens, I will use the hamstrings for the ACL reconstruction, and turn to an alternative graft — such as the rectus femoris — to reconstruct the MPFL instead.

Working on the kneecap

Small incisions are made around the patella. In this technique, I use a dual button method — creating tunnels in both the kneecap and the femur (thigh bone), positioned with image guidance (live X-ray) to confirm accurate placement. Sockets are prepared within the patella itself, and the graft is inserted into these sockets and secured in place with sutures.

Working on the femur

Attention then shifts to the femur. I identify the correct tunnel position and drill the tunnel across the thigh bone, again under image guidance.

The graft is tunnelled through the correct soft-tissue layer to reach this femoral socket, then passed across and secured — completing the reconstruction.

The result

A post-operative X-ray confirms the graft and buttons are sitting exactly where intended. It's a procedure with several small, precise incisions, and one that takes a coordinated surgical team to execute smoothly from patella to femur.

If you have any questions before the surgery, feel free to ask me.