Medial Patellofemoral Ligament (MPFL) Tunnelless Reconstruction

When someone dislocates their patella (knee cap) the structures on the medial side of the patella are torn. Sometimes after a dislocation, you can rehabilitate the knee in physical therapy and the patient can return to activities without recurrent (repeat) dislocations. However, some patients continue to experience instability and dislocations. With each dislocation, there is a risk for associated injuries to the cartilage in the knee. After conservative treatment and physical therapy, if someone continues to have recurrent dislocations, surgery to reconstruct the medial patellofemoral ligament (MPFL) is recommended.

There is a wide variety of techniques used to treat recurrent dislocations of the patella. Many of these surgeries are very involved and can require drilling tunnels and/or cutting bones and tissues to re-align the way the patella tracks along the femur (thigh bone). This alters the normal anatomy and predictably results in an increased risk for developing arthritis. Dr. Chudik prefers to preserve the normal anatomy and anatomically reconstructs the medial patellofemoral ligament (MPFL) without drilling tunnels or cutting the bone to stabilize the patella and prevent further dislocations. The reconstruction is done with a tendon graft (usually a hamstring tendon from the same knee) to create a new MPFL. The graft is secured with small anchors to the femur and the patella.