The medial patellofemoral ligament (MPFL) has been recognized as the most important medial restraint to lateral patellar translation. The reconstruction of MPFL can help restore stability in patients with failed distal realignments, patella alta, trochlear groove insufficiencies, medial retinacular deficiencies, torsional limb malalignments, and other abnormalities. Knowledge of the anatomy of the MPFL has progressed, leading to improved strategies for anatomical MPFL reconstruction.

The medial patellofemoral ligament has been recognized as the most important medial structure preventing lateral dislocation or subluxation of the patella. Numerous surgical techniques have been described to reconstruct this important structure in patients with patellofemoral instability. This paper reviews the relevant anatomy and biomechanics, published reconstruction options, and describes the surgical technique used at our institution using semitendinosus autograft to reconstruct the medial patellofemoral ligament.