Medial reefing

Written by Dr Sheila Strover on March 14, 2025

Medial reefing is a surgical procedure to tighten the tissues on the medial aspect of the patella. It is being used less and less as studies show it is not very effective. Page updated April 2024 by Dr Sheila Strover (Clinical Editor)

normal medial side of patellamedial reefing

Why has medial reefing traditionally been performed?

Medial reefing tightens up the superficial layers on the medial side of the patella to try and better align the patella in its underlying groove, and also to counter any excessive patellar instability that may have resulted from a prior lateral release.

But this surgical procedure has not proven very effective and is being replaced with medial patellofemoral ligament reconstruction (MPFL-R ).

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Relationship of medial reefing to lateral release

Medial reefing has often been performed in association with lateral release or lateral retinacular lengthening in patients who have problems with instability of the patella.

Because lateral release surgery has in the last two decades fallen out of favour, medial reefing is no longer that commonly performed.

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Why MPFL reconstruction is nowadays preferred to medial reefing

MPFL reconstruction may be done after a patellar dislocation event has torn the medial patellofemoral ligament.

The procedure uses a harvested ligament and bone tunnels in both patella and femur. It gives a strong reconstruction but is quite invasive. Medial reefing, in contrast, tightens up the soft tissues in the same area without using bone tunnels.

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