What question did this study set out to answer?

To assess the effectiveness of medial patellofemoral ligament reconstruction versus active rehabilitation in preventing recurrent lateral patellar dislocation.

February 11, 2026Open Access

Medial Patellofemoral Ligament Reconstruction vs Nonoperative Treatment for Recurrent Lateral Patellar Dislocation: Three-Year Results From a Randomized Controlled Trial

Key Points

To assess the effectiveness of medial patellofemoral ligament reconstruction versus active rehabilitation in preventing recurrent lateral patellar dislocation.
Randomized controlled trial design
Participants aged 12 to 30 with recurrent lateral patellar dislocation
Comparison between isolated MPFL reconstruction and active rehabilitation
Follow-up assessed patient-reported knee function scores at baseline and 3 years
5 out of 30 patients (16.7%) in the MPFL group reported instability after 3 years compared to 15 out of 31 patients (53.6%) in the control group
Odds ratio for instability in control group was 5.8
Both groups showed significant improvements in knee function scores over time, but no significant differences between groups at follow-up

Abstract

Background: Medial patellofemoral ligament reconstruction (MPFL-R) is the primary surgical intervention for recurrent lateral patellar dislocation (LPD). Isolated MPFL-R is recommended for patients without anatomic high-risk factors that predispose to further dislocations. Purpose: To compare instability recurrence in patients with recurrent LPD without underlying anatomic risk factors treated with MPFL-R versus active rehabilitation. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: Patients aged 12 to 30 years with recurrent LPD and no underlying anatomic high-risk factors for further dislocations—specifically, no severe trochlear dysplasia (Dejour D) and a tibial tuberosity–trochlear groove distance ≤20 mm on computed tomography—were randomized to receive knee arthroscopy with isolated MPFL-R followed by active rehabilitation (MPFL group) or knee arthroscopy without reconstruction followed by active rehabilitation (control group). The primary outcome was subjective persistent patellar instability at 3 years. Knee function at baseline and 1 and 3 years was assessed by the following patient-reported outcome measure (PROM) scores: Knee injury and Osteoarthritis Outcome Score (KOOS), Kujala Knee Score, Cincinnati Knee Rating System, and Noyes Sports Activity Rating Scale. Results: Between 2010 and 2019, 61 patients (72.1% female) were included in the study and randomized, with 30 assigned to the MPFL group and 31 to the control group. At 3-year follow-up, subjective persistent patellar instability was reported by 5 patients in the MPFL group (16.7%) versus 15 patients in the control group (53.6%), corresponding to an odds ratio of 5.8 (95% CI, 1.7-19.4; P = .003). Both groups reported significant improvements in all PROM scores from baseline to 3 years. However, no significant differences in PROM scores were observed between the groups at any follow-up time point. Conclusion: Isolated MPFL-R was more effective than active rehabilitation alone in preventing patellar instability after 3 years. Trial Registration: ClinicalTrials.org (NCT02263807).

Medial Patellofemoral Ligament Reconstruction vs Nonoperative Treatment for Recurrent Lateral Patellar Dislocation: Three-Year Results From a Randomized Controlled Trial

Key Points

Abstract

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