Purpose of Study: The role of surgery in the treatment of acute patella dislocation has always been controversial with procedures falling in and out of popularity.

Since the Medial Patellofemoral ligament was first described in 1979, its importance as a prime patella stabiliser has been defined, and procedures for its repair and reconstruction have been described.

We believe that the MPFL has a pivotal role in the stability of the patella, and is disrupted in all patients with acute patella dislocation. Failure to address this will inevitably lead to ongoing patellofemoral symptoms.

Methods: We summarise the current literature detailing the anatomy and biomechanical properties of the native as well repaired MPFL.

We present our own experience of treating acute patella dislocations by repair of the Medial Patellofemoral Ligament, in acute cases.

A lesion can occur anywhere along its length from the superomedial patella to a point superoposterior to the adductor tubercle. The technique of repair has to address the site of primary disruption, as well as any associated intraarticular knee injuries.

Results: In one series we have shown that of 13 patients who presented with acute patella dislocation, 10 had an MRI proven lesion of the MPFL and went on to have an open repair which reconstituted patella stability.

Conclusion: A lesion of the MPFL is the primary pathology in acute patella dislocation, and we believe that this lesion warrants surgical intervention to avoid progressive symptoms.