Rehabilitation following MPFL Reonstruction

Medial Patellofemoral Ligament Reconstruction Rehab Protocol

Stage

• Pre-operative
• Restore full knee range of motion (ROM)
  Maximise lower limb strength (focus on VMO and gluteal complex)
  Educate on post-operative rehabilitation
  Fit and supply PF brace
  Teach PF taping techniques
  Book Physio apt for 2 days after post surgical apponitment
• Weeks 0-2
• Swelling reduction & regular icing (20 min. every 2-3 hours)
  Compression with tubigrip,
  Regular rest and elevation
  Encourage calf and quads contractions, Hamstring, calf and ITB stretches
  Static and inner range knee contractions (0-30°), calf pumps, hip coronal and sagittal resistance exercises
  Full Weight Bearing with crutches until balance and gait pattern normalises
  Active and passive ROM (0-60°)
  PF brace over tubigip from day 1
• Weeks 2- 6
• Medial PF glides to commence (no lateral glides)
  Daily scar massage: Bio-oil
  Progress to eccentric WB quads sets (with hip in neutral and internal rotation only)
  Stationary bike ( work up to 20 min)
  Low resistance squat and leg press (0-45°)
  Gait re-training aiming to optimize heel strike and toe off
  Gradual restoration of full active and passive ROM
  PF brace over tubigrip
• Weeks 6-12
• Commence lateral, superior and inferior PF glides
  Foam roller for ITB, gluts, calf and HS releases
  Progress to gym-based program
  Leg press and squat (0-60°), calf raises, hip abduction, hip adduction, hip flexor, HS curls Proprioceptive re-training eg wobble board and mini-tramp
  No open chain exercises, deep lunges
  Add elliptical trainer / stepper machine / rower machine/ Freestyle swimming
  PF taping during rehabilitation; PF brace during all other activities
• Weeks 12+
• Sports-specific activities
  Progression of gym-based rehabilitation as above with increased resistance
  Discard PF brace during normal activities; PF taping during sports for minimum 12 months
  Commence jogging and swimming with flipper
  2 -3 months lateral movements, single leg hops and landing techniques Return to sports once all mile stones met and cleared physio / surgeon.