Medial Patellofemoral Ligament Reconstruction: Current Techniques, Outcomes, and Controversies

Abstract

Recurrent patellofemoral instability is a common and disabling condition, particularly among young, active individuals. The medial patellofemoral ligament (MPFL) is a critical stabilizer of the patella, and its reconstruction has become a widely accepted surgical option following failed conservative treatment. While outcomes are generally favorable, significant variation persists in surgical techniques, patient selection criteria, and postoperative rehabilitation protocols. Furthermore, debates persist around the optimal graft choice, tunnel positioning, and the role of adjunctive bony procedures. This review explores the current approaches to MPFL reconstruction, summarises clinical outcomes, and discusses key controversies in the field. Improved standardization in technique, outcome reporting, and patient stratification is essential to refine treatment algorithms and optimize results.