Rehabilitation following MPFL Reonstruction

Medial Patellofemoral Ligament Reconstruction Rehab Protocol


  • 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.