MPFL Reconstruction

Post-op recovery	First 2 weeks	Date
Goals	Protect the knee and surgical incision Recover from swelling and inflammation Control of post-surgical pain
Precautions	Partial weight bear with crutches (up to 20kg) Do not bend knee more than 90 degrees
Recommendations	Rest and elevate as required Ice the knee up to 3 times a day – particularly in the first 72 hours Range of motion exercises of ankle Range of motion exercises of hip Gentle movement of the knee from full extension to 90 degrees of flexion as pain and swelling allows
Suggested exercises	Static quads contraction Supine straight leg raise Ankle pumps Supine bed supported knee bend Sitting supported knee bend Supine knee extension – foot elevated/supported Standing knee extension

Phase 1	Week 2 to week 6
Goals	Achieve range of motion from 0-90 degrees Comfortably walk normally
Precautions	Do not bend knee more than 90 degrees
Recommendation	Gradually come off crutches taking full weight through leg When standing, push knee straight to help achieve full extension Increase range of motion from full extension to 90 degrees Begin strengthening knee Hip and gluteal muscle strengthening Ankle range of motion and strengthening
Suggested exercises	Wall slide mini squat Double leg squats (0-60) Sitting unsupported knee extension and flexion Single leg stance – knee straight, knee flexed Straight leg raise Step ups Double calf raises Side leg raise – knee straight, knee flexed Gluteal band exercises Bridging with gluteal contraction

Phase 2	Week 7 to week 12
Goals	Comfortably walk normally Gain full range of motion Begin strengthening
Precautions	Avoid running Do not return to athletic activity before full strength and neuromuscular control has been gained
Recommendations	Fully weight bear as able Passive stretching to achieve full extension and flexion Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Neuromuscular control and co-ordination of leg
Suggested exercises	Double leg squats (0-60) Sitting unsupported knee extension and flexion Single leg stance – knee straight, knee flexed Straight leg raise Step ups Double calf raises – progress to single calf raise Side leg raise – knee straight, knee flexed Gluteal band exercises Bridging with gluteal contraction Exercycle – low resistance, short interval

Phase 3	3 Months – 6 months
Goals	Gain full function and strength
Precautions	Avoid collision sports or high risk recreational activity Return to vigorous athletic activity as physiology allows (rapid return to rigorous strength training or endurance and speed training can lead to tendinopathies or injury)
Recommendations	Return to running in sensible progressive time frame Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Neuromuscular control and co-ordination of leg Progress into sport specific functional training
Suggested exercises	Double leg squats (0-90) Single leg squats Single leg hop Step ups – increase height Hop ups Step downs Side hops Resisted quads and hamstring weight training Gluteal band exercises Bridging Exercycle – increase resistance and training length