Home Sports MedicineMPFL Reconstruction (Patellar Stabilization Surgery) in India

MPFL Reconstruction (Patellar Stabilization Surgery) in India

Surgical reconstruction of the medial patellofemoral ligament to prevent recurrent kneecap dislocations.

Overview

MPFL (Medial Patellofemoral Ligament) reconstruction is an arthroscopic or minimally invasive surgical procedure designed to restore stability to the kneecap (patella) in patients who suffer from recurrent patellar dislocations or chronic patellar instability. The MPFL is the primary soft tissue restraint that prevents the patella from dislocating laterally (to the outside). When this ligament is torn or stretched, the kneecap can repeatedly slip out of place, causing pain, instability, and difficulty with sports and daily activities. Dr. Gurudeo Kumar at Arthoscenter has performed over 180 MPFL reconstruction procedures with a 95% success rate in preventing recurrent dislocations, making him one of the most experienced sports medicine surgeons in Bihar for patellar instability treatment. The procedure involves using a graft (typically from the patient's own hamstring tendon or donor tissue) to reconstruct the torn MPFL, restoring normal patellar tracking and knee stability. This surgery is particularly beneficial for young athletes, active individuals who have experienced two or more patellar dislocations, or patients with chronic patellar instability that limits their activity level. The procedure can be combined with other stabilization procedures if there are underlying anatomical risk factors like trochlear dysplasia or patella alta. Book your online video consultation at ₹999 to determine if MPFL reconstruction is the right solution for your patellar instability.

Symptoms & Indications

This surgery may be recommended if you experience:

History of two or more kneecap dislocations

Feeling of kneecap slipping or "giving way"

Pain on the inside (medial) aspect of knee

Apprehension when twisting or changing direction

Visible kneecap maltracking or lateral shift

Swelling after activities or sports

Difficulty with cutting, pivoting, or jumping

Chronic knee instability despite physiotherapy

Fear of re-dislocation limiting activities

Positive patellar apprehension test on examination

Procedure Details

Duration

1.5-2.5 hours

Anesthesia

Spinal or general anesthesia

Preparation for Surgery

Pre-operative evaluation includes detailed knee MRI to assess MPFL tear, patellar tracking, cartilage damage, and bony anatomy. CT scan may be obtained to measure tibial tubercle-trochlear groove (TT-TG) distance and assess for trochlear dysplasia. Physical examination includes patellar apprehension test, J-sign assessment, and evaluation of ligamentous laxity.

Surgical Steps

Spinal or general anesthesia administration

Diagnostic arthroscopy to assess cartilage and meniscus

Harvesting of hamstring tendon graft (gracilis or semitendinosus)

Small incision made over medial aspect of knee

Identification of anatomic MPFL femoral attachment point

Drilling of femoral tunnel at Schöttle's point

Preparation of patellar attachment site on medial border

Graft passage and fixation to patella with suture anchors

Graft tensioning with knee in 30-40 degrees flexion

Femoral fixation with interference screw or button

Verification of proper patellar tracking through full range

Closure of incisions and application of knee brace

Recovery Timeline

What to expect during your recovery journey

Week 1-2

Knee brace locked in extension, non-weight bearing with crutches, gentle quad sets and ankle pumps, ice and elevation, pain management

Week 3-6

Progressive weight bearing as tolerated, brace unlocked for controlled range of motion (0-90 degrees), begin formal physical therapy, gentle strengthening exercises

Week 7-12

Discontinue brace, progress to full weight bearing, increase range of motion to full, advance strengthening program, proprioception training

Month 4-6

Sport-specific training begins, agility and cutting drills, progressive return to running, continued strengthening focus on VMO (vastus medialis oblique)

Month 7-9

Return to competitive sports with surgeon and physiotherapist clearance, continued strengthening and conditioning, bracing may be recommended for high-risk sports

Long-term

Lifelong VMO strengthening and patellar stability exercises, proper warm-up before sports, awareness of re-injury signs, annual follow-up recommended

Frequently Asked Questions

Common questions about this procedure

Q1.What is the success rate of MPFL reconstruction?

MPFL reconstruction has an excellent success rate of 90-95% in preventing recurrent patellar dislocations when performed on properly selected patients. At Arthoscenter, Dr. Kumar achieves a 95% success rate with over 180 procedures. The surgery significantly reduces re-dislocation risk from 50-80% (without surgery) to less than 5% with proper rehabilitation.

Q2.When can I return to sports after MPFL reconstruction?

Return to competitive sports typically takes 7-9 months, though this varies by sport and individual healing. Low-impact activities like swimming can begin at 3-4 months. High-risk sports involving cutting and pivoting (basketball, football, cricket) usually require 8-10 months. Dr. Kumar uses functional testing and strength assessments to determine readiness for sport return.

Q3.Do I need MPFL reconstruction after just one dislocation?

Not necessarily. After a first-time dislocation, conservative treatment with bracing and physiotherapy is usually recommended for 3-6 months. Surgery is typically indicated after 2 or more dislocations, or after first dislocation if there are significant risk factors like trochlear dysplasia, patella alta, or large cartilage injury. Your consultation will help determine the best approach.

Q4.Will my kneecap ever dislocate again after MPFL reconstruction?

The re-dislocation rate after MPFL reconstruction is very low (less than 5%) when proper surgical technique is used and rehabilitation is completed. However, if underlying bony abnormalities (like severe trochlear dysplasia or excessive TT-TG distance) are not addressed, risk may be slightly higher. Dr. Kumar assesses all risk factors and combines procedures when necessary.

Q5.What is the cost of MPFL reconstruction in Bihar?

At Arthoscenter, MPFL reconstruction costs between ₹2.2-3.2 lakhs depending on graft choice (autograft vs allograft), hospital stay, and whether additional procedures are needed. The surgery is covered under PMJAY and BSKY schemes for eligible patients. This includes pre-operative MRI, surgery, implants, post-operative physiotherapy protocols. Book a ₹999 consultation for personalized cost estimate.

Q6.Is the surgery done arthroscopically?

MPFL reconstruction is typically done using a combination of arthroscopic and open techniques. Diagnostic arthroscopy is performed first to assess cartilage damage. The MPFL reconstruction itself requires small open incisions (3-4 cm) for graft passage and fixation. This hybrid approach provides the benefits of minimally invasive surgery while ensuring accurate anatomic reconstruction.

Q7.What happens if I don't get MPFL reconstruction?

Without surgery, recurrent dislocations are very likely (50-80% risk). Each dislocation causes additional cartilage damage, potentially leading to early arthritis. Chronic instability limits sports participation and quality of life. Over time, repeated dislocations can cause permanent cartilage loss and make eventual surgery more complex with potentially worse outcomes.

Q8.Can both knees be done at the same time?

While technically possible, bilateral (both knees) MPFL reconstruction is generally not recommended due to prolonged immobilization requirements and rehabilitation challenges. If both knees need surgery, they are typically staged 3-6 months apart to allow proper rehabilitation of the first knee before addressing the second.

Q9.Will I need any other procedures along with MPFL reconstruction?

Additional procedures may be needed if there are underlying bony abnormalities. These can include tibial tubercle osteotomy (if TT-TG distance >20mm), trochleoplasty (for severe trochlear dysplasia), or cartilage repair procedures. Dr. Kumar performs comprehensive pre-operative imaging to identify all risk factors and plan combined procedures if needed for optimal stability.

Q10.How painful is the recovery from MPFL reconstruction?

Post-operative pain is typically moderate and well-controlled with oral medications. Most patients rate pain 4-6/10 in the first week, decreasing to 2-3/10 by week 2-3. The graft harvest site (hamstring area) may be sore initially. Pain is generally less than ACL reconstruction. Proper pain management, ice therapy, and following rehabilitation protocols help minimize discomfort.

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