Hi! Im so sorry for the delay in this response, I just happened to stumble upon an email showing me that you had posed a question. I have went through about five procedures on this knee and I would have a load of advice for you, but advice is only as good as you feel led to either listen or not if that makes sense?? My life has never been the same since I had my mpfl with t t o!! And I can tell you that I have been very active and healthy and worked out for many years and this surgery was really in my opinion overdone from everything I have learned now? most Orthopedics say the tibial tubercle osteotomy alone is enough for what was going on for me which my diagnosis was subluxed kneecap, and it was days away from probably being dislocated. The surgery that I had done is one thing that I can say if I could turn back the hands of time I would have not. I didn't have a choice because my knee cap was popping out but I would not have allowed both type procedures to be done because it was done so well ... that my kneecap settled in a place that was pulling medially so I've had a lot of reconstruction since! Uva is top notch, and my surgeon ws too. Hes on medial pattela boards and well decorated..imo, being a univ hospital, they love these complex surgeries as its a teaching hospital .. vs needing to be more conservative w surgery types. Make sense?