REHABILITATION PROTOCOL:MPFL RECONSTRUCTION

Phase I (Weeks 0-2)

• Hinged Knee Brace: Locked in extension for ambulation (WBAT in extension), open 0-90° for ROM exercises

• Range of Motion: At least 3x/day max motion to 0-90°, goal at first visit 0-90° AAROM, AROM, very gentle PROM

• Strengthening:  Quad sets, SLR with brace locked in extension, Heel slides

• Other: Modalities PRN (E-STIM, ICE, Patellar Glides), crutches for ambulation

Phase II (Weeks 2-6)

• Brace: Locked in extension for ambulation, open 0-120° for ROM exercises, wean from brace beginning at 6 weeks

• Range of Motion: Increase AAROM, AROM, PROM – Goal of 90° by 6 weeks or consider MUA

• Strengthening: Core, Gait training, closed chain extension exercises, tow raises, balance exercises, exercise bike as tolerated

• Other: Modalities PRN (E-STIM, ICE, Patellar Glides), wean from crutches as tolerated.

Phase III (Weeks 6-12)

• Brace: None

• Range of Motion: AAROM, AROM, PROM to obtain full ROM (prone hangs, etc.)

• Strengthening: as in Phase II, advance closed chain exercises, begin proprioception exercises, add stairmaster/elliptical

• Other: Modalities PRN (E-STIM, ICE, Patellar Glides)

Phase IV (Weeks 12+)

• Brace: None

• Range of Motion: Full

• Strengthening: Core, closed chain quads, HS strengthening, sports specific training may begin

• Other: Modalities PRN (E-STIM, ICE, Patellar Glides, HS stretching)

• RETURN TO SPORT: 4.5 – 6 months from surgery, Cybex testing prior to return