MPFL Reconstruction Rehabilitation Protocols

20 MPFL Reconstruction rehabilitation protocols from 17 institutions, published 2014–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Institution	Weight-Bearing	Key Restrictions
Children's Hospital of Philadelphia — Medial Patellofemoral…	TTWB with crutches wks 1-2; WBAT wean crutches wk 2; brace locked full extension (-10 deg…	Brace locked extension at all times wks 1-2 (incl sleep); increase flex 10 deg/day Phase I (CPM if available…
Dr. David P. Trofa MD (Columbia University Medical Center)	WBAT in brace locked extension; crutches x 2-4 wks; D/C crutches when normal gait	Brace locked extension x 2 wks; brace 0-90 wks 2-4; D/C brace wk 6; no lateral patellar mobilizations; no…
Lahey Hospital & Medical Center — Medial Patellofemoral…	WBAT with brace locked → FWB	Brace locked in extension for gait/ADLs 0-4-6 wks; ROM limited to 0-90 deg Phase I; no active extension Phase…
Lahey Hospital & Medical Center — with Tibial Tubercle…	Brace locked in extension wks 0-6; progressive WB; brace off after wk 8	ROM restricted 0-6 wks (full ext wk 1-2, 30° wk 3, 60° wk 4, 90° wk 5, 120° wk 6); medial patellar glides…
Mammoth Orthopedic Institute / Sierra Park PT — Medial…	WBAT with 2 crutches; brace locked 0° for ambulation x6 weeks; FWB in brace locked 0° by…	Brace locked 0° for ambulation x6 weeks; PROM 0-30° flexion x2 weeks; avoid lateral patellar glides…
Massachusetts General Hospital — Medial Patellofemoral…	Brace locked, PWB wks 0-1; WBAT with crutches per MD; walk without crutches when no…	Keep knee straight and elevated when sitting/lying — do NOT rest with towel under knee; TTO concomitant…
Massachusetts General Hospital — Pediatric	PWB 25% with brace locked in extension wks 0-2; WBAT Phase II; FWB Phase III	Brace locked, PWB 25% wks 0-2; unlock brace once SLR without lag; DC brace at 6 wks per surgeon; knee flexion…
Mountain Orthopaedics	WBAT with crutches wk 1 (balance only); encourage FWB ASAP	Knee brace locked in full extension x 2 wks; transition out of brace wks 3-4; D/C brace by wk 4; avoid all…
NYU Langone Health	WBAT	Brace locked at 0 for ambulation and sleeping 0-6 wks; ROM limited to 30 deg 0-2 wks; goal 90 deg by wk 6…
Ohio State University Wexner Medical Center — Medial…	WBAT with crutches wk 0-2 in brace locked extension; FWB by wk 2-3; D/C crutches wk 3-4	Brace locked extension x 2 wks; brace unlocked 0-90 deg wks 2-4; D/C brace wk 6; no isolated hamstrings…
Orthopaedic Associates of Maine	WBAT; knee immobilizer for ambulation 2 wks; FWB by end of wk 2	Knee immobilizer for ambulation 2 wks; regular patellar mobilization (grade I-II if good mobility ≥3…
Orthopedic & Sports Medicine Specialists (OSMS)	Brace locked in extension for ambulation/sleeping x2 wks Phase I (may unlock while…	Avoid active extension Phase I; avoid post-activity swelling and closed chain exercises on land past 90 deg…
Parker Orthopedics (Dallas, TX)	WBAT with crutches; many patients have pain limiting WB first 2 wks; crutches PRN	Avoid dynamic knee valgus and femoral IR throughout — maintenance of neutral LE alignment (ASIS over knee…
Sanford Health — MPFL Reconstruction	WB immediately in locked brace (full extension)	Brace locked x 6 wks; knee flexion limited 0-90° x 6 wks; no biking x 6 wks; prevent hip internal rotation…
Sutter Health / Palo Alto Medical Foundation	Touchdown WB (1/6 body weight) wks 1-2; WBAT wean crutches wks 2-6; FWB wks 6+; brace…	Brace locked 0° wks 1-2; no WB exercise in flexion >90° wks 2-6; patellar stabilization brace for sport…
University of Delaware Physical Therapy — with Proximal…	WBAT in immobilizer locked at full extension for 4 weeks; progress to functional brace	No NMES over VMO; no MVIC until 12 weeks; no Burst test until 16 weeks; hop testing at 20 weeks; running when…
University of New Mexico (UNM) Sports Medicine — (with or…	WBAT; if TTO: brace locked in extension Phase I; discontinue crutches as swelling and…	If TTO: brace locked in extension 0-2 weeks, open to 0-90 degrees weeks 2-6, D/C brace at 6-12 weeks; no…
University of Virginia Orthopaedic Surgery	50% WB weeks 0-2; WBAT in brace weeks 2-4; progress to FWB	Brace 0-90° weeks 0-4; no ambulation without brace first 4 weeks; avoid lateralization of patella; avoid…
University of Virginia Orthopaedic Surgery — / Tibial…	50% WB for 6 weeks (more conservative than MPFL alone)	50% WB for 6 weeks; no ambulation without brace first 6 weeks; brace 0-70° weeks 0-2, 0-90° weeks 2-4, unlock…
UW Health Sports Medicine — MPFL Repair and Reconstruction	WBAT with crutches; post-op brace locked in extension initially	Post-op brace locked in extension; avoid rotational knee movements; no impact until Phase III (12+ weeks)…

MPFL Reconstruction Rehabilitation Protocols

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