Medial Patellofemoral Ligament Reconstruction for Patellar Instability in a Patient with Below-Knee Amputation

Case: A 15-year-old girl with a right below-knee amputation (due to meningococcal septicemia and purpura fulminans) presented with patellar instability and Type D trochlear dysplasia. Management was complicated by extensive scarring and 8 prior residual limb revisions. To address instability, the patient underwent medial patellofemoral ligament (MPFL) reconstruction using an ipsilateral semitendinosus autograft, following MRI verification of tendon viability. At 12-month follow-up, stability was restored, allowing successful return to active prosthesis use and mobility without complications. Conclusion: MPFL reconstruction using an ipsilateral autograft effectively treats instability in below-knee amputees while avoiding donor-site morbidity in the contralateral limb.