Editorial Commentary: Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability—Single or Double Bundle: Does It Really Matter?

Medial patellofemoral ligament reconstruction is considered by most surgeons to be the standard of care for patients with recurrent lateral patellar instability, although the choice of how and when to address concomitant bony pathology (trochlear dysplasia, patella alta, or coronal-plane malalignment—elevated tibial tubercle–trochlear groove distance) remains unclear. Medial patellofemoral ligament reconstruction works to re-establish the primary static restraint to lateral translation of the patella and reduce the risk of recurrent dislocation. Regardless of graft choice or construct, this operation works well to prevent recurrent instability. Despite the low recurrent instability rates, several significant complications can still occur, one of the most serious being patellar fracture. We continue to look for ways to improve stability and decrease risk with this operation.