Sixty-one patients with recurrent lateral patellar dislocation without underlying anatomical high-risk factors for future dislocation were randomized to receive a medial patellofemoral ligament reconstruction (n=30) or active rehabilitation through a physiotherapist (n=31). Outcomes of interest included the rate of persistent instability, knee flexion, positive apprehension test, and patient reported outcomes measures (Cincinnati; Kujala; Lysholm; Knee Injury and Osteoarthritis Outcome Score [KOOS] sport; KOOS quality of life), measured up to 12 months post-treatment. Results revealed a significantly lower persistent patellofemoral instability (6.7% vs. 41.9%, p=0.005) and less apprehension in the reconstruction group (16.7% vs. 38.7%, p=0.021). No differences in patient-reported outcome measures were reported.