I dislocated my kneecap the other day off the bike, and just got back from the Orthopedic Surgeons. It looks like I'm going to need MPFL surgery (Medial Patellofemoral Ligament Reconstruction), and am wondering what other roadies have been through this before. How long were you off the bike after the surgery? How long, if ever, did it take to get back to 100%? Anything you wish you knew beforehand?

I'm pretty confident in the surgeon, he specializes in sports medicine and has seen a lot of athletes. I just want a little bit better of an idea of what I'm getting myself into before going under the knife.

Nobody? I know more people on here have had knee problems, I'm sure there are a few of you that have had this surgery done.

I recently worked as a Physical Therapist 3 years in a outpatient clinic in Pittsburgh that serviced most of the professional athletes and many many others. I knew most of the ortho surgeons in the area and treated their patients.


I have never heard or seen anyone who has had this procedure done. In fact, I had to look up the procedure... never heard of it. sounds....interesting. What kind of long term studies have they done regarding harvesting your own hamstring tendons? (I know they have done these as many ACLs are now done with autologous hamstring tendons....

In a biomechanics class, we had a guest lecturer who works with a group of surgeons who have tried every type of ACL reconstruction over the last few decades. I asked him the same question about taking the semitendinosis and semimembranosus tendons...essentially, they don't really know, but people lose about 10% of their knee flexion strength.

I think if I were you I would get a second option. Not that I don't trust the doc. I just think it makes good sense.
Good luck I wish you well and a speedy recovery.

From what Ive seen firsthand, the only problems I saw were some donor site tenderness. Never saw any specific hamstring or other knee problems (patellofemoral, ITB, etc) in any of the patients 5 years out.

As for getting a second opinion..... keep a few things in mind. Surgeons make money doing surgeries, not conservative treatment. Also, it appears this procedure is relatively new (2007?). I like my procedures done with the time-tested ones that we know the outcomes and have lots of docs doing lots of them.

I don't know if this is relevant but here goes ......

I blew out my left knee playing soccer in 1983; complete tear in my ACL and 98% tear in my medial-colateral plus some other minor soft tissue damage. The surgeon who repaired my knee took a cold chisel and hammer to my paterllar tendon to strip off a bit. Two holes were drilled near the attaching points of my ACL and the bit of patellar tendon was threaded through and stapled into place. What was left of my old ACL was kind of wound around the new ACL.

I was in PT for ~1 year and was able to go back to playing soccer after ~18 months with a de-rotation brace. I lost a bit of lateral mobility but straight ahead speed was ok.

Techniques have improved drastically since 1983 so I don't think you'll end up with the 2 8" scars on either side of my knee. However your situation would depend on how badly you wrecked your knee. PT times may be reduced as well.

Ditto. Get a second opinion.

Good luck with your knee.

I can attest to this.. I'm at about 3-4 years out from ACL reconstruction using a hamstring graft, and I'm probably at least 20% weaker on that leg (when doing a leg curl or something similar).

I have a big history of knee issues also. I would recommend the second opinion also
AND try to speak to physiotherapists who are familiar with these patient.

Physiotherapists tend to have a better real world experience with patients.

Medial and Lateral ligaments work to stabilize the knee from swinging outward or inward and are not as critical as the ACL but you should still seek a second opinion.

Always remember with knee problems, your NUMBER ONE priority is if/how the issue will affect the cartilage in your knee
because once the cartilage wears away from wear/tear or a loose out of alignment knee you can't get it back and your last resort is knee replacement down the road.

The tendency of orthopedic surgeons to over-operate is frightening. It's not that they're in it for overt bad intentions, like to make a buck off you, but when you're a hammer, everything starts to look like a nail. A lot (most?) of these ortho surgeries have unproven outcomes because they're new as well. That doesn't mean that they're bad procedures just because they are new, but you do have to be careful before going under the knife. Every operation will leave scar tissue and possible other damage that may raise its ugly head years down the road. 2nd opinions are very reasonable.

I'm looking into getting a second and third opinion next week. I want to make sure this is done the right way the first time, I refuse to be one of those guys that has nagging knee issues for years.

A few years ago I was told that one of the ligaments holding my knee cap in place was weak, and that it would get worse down the road. They told me then that I would likely need an operation at some point. After going a few years without any problems I forgot about it. At the time I was a beyond-broke college student, so surgery was just about the last thing I wanted to do.

The doctor that said I needed sugery hasn't done any MRIs yet, and hasn't seen the old ones. All he did was poke the knee a bit, test its flexability, and take a look at a few X-rays. I assume that the guy has seen this injury a few times since he specializes in athletes and knees, but its still a bit concerning that he was so quick to diagnose the problem.

Medial Collateral ligament is different than medial patellar ligament.

bone patella bone ACL reconstructions are still fairly common, although being displaced with more hamstring graphs.

an MRI is basically not going to show any instability. and an xray is not going to show any soft tissue injury.

main idea to take away.... dont listen to other people's experiences on the net or at the mall. I see people all the time doing something they shouldnt be, because their "friend had the same thing/surgery".... but tats far from the truth. Getting opinions gets people anxious, then they start demanding for more unnecessary procedures (diagnostic imaging being handed out like candy).

if you want an opinion, go see other ortho docs or PTs. that includes pre-op, post-op, rehab. Although you do get some good info, the boards are generally a good way to get a lot of bad, ignorant, and sometimes damaging information

John, I wish you luck with your treatment. Who was the doc? The partner of my orthopedic surgeon for my collarbone specializes in knees for athletes. Don't remember his name offhand but I could get it for you. There were tons of pictures of local athletes in their office and I think he was involved with several teams at UCSB.

I bet that was the guy I saw, Ryu.

I'm getting an MRI tomorrow and then seeing another ortho. Not quite sure where I am going from there yet.

Yeah, that was it. He's supposed to be the best in town from what I understand.

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Hi. I just got told I need this surgery as well. I can't find much online about it. Would really like to talk to you about what you ended up doing.

Not sure if I can put contact info on here... you can probably send me a message through the site.

my wife had the surgery many years ago. She is not an athlete and we did not ride back then, but she did a fair amount of physical therapy and was not completely "back in action" for about 6 months. Her repaired knee now is better than the natural one.

Googled it. Here's an interesting guide for PT following Medial Patellofemoral Ligament Reconstruction:

https://www.uwhealth.org/files/uwheal...l_protocol.pdf

Unrelated, I had 100% reconstruction of an severed ACL using the patellar tendon. That leg is 100% and the knee more stable than the other, but the surgery was nearly 20 years ago. It took a few years to get there.

It makes me happy to hear two new positive accounts of knee surgery. My MRI is scheduled later today and I think I have to go through with this reconstruction.