MPFL Reconstruction — Medial Patellofemoral Ligament Reconstruction

Children's Hospital of Philadelphia · Dr. Theodore Ganley MD; Dr. Kathleen Maguire MD; Dr. Brendan Williams MD; Dr…

Weight-Bearing

TTWB with crutches wks 1-2; WBAT wean crutches wk 2; brace locked full extension (-10 deg on brace) at all times except PROM exercises; sleep in brace locked

Key Restrictions

Brace locked extension at all times wks 1-2 (incl sleep); increase flex 10 deg/day Phase I (CPM if available: start 30 deg, increase 10 deg/daily); brace unlocked to 90 wks 2-4; D/C brace wk 6; no lateral patellar mobilizations; surgeon clearance required at 3, 6, and 9 months to progress; return to full activity at 9 months if all criteria met; earlier return to sport per surgeon based on performance

Timeline & Phases

6 phases: Wks 1-2 (TTWB, brace locked, PROM/flex 10 deg/day, NMES 75 Hz, SLR in brace), Wks 2-4 (WBAT, brace 0-90, bike wk 3-4), Wks 4-8 (D/C brace wk 6, begin CKC, progressive strengthening), Wks 8-12 (advanced strengthening, begin jogging criteria-based), 3-6 months (sport-specific drills, agility), 6-9 months (full return to sport, surgeon clearance)

Notes

2023 revised; pediatric-focused; NMES parameters: 20-50 sec OFF, 10 sec ON, 2 sec RAMP, 75 Hz, 400 µsec, 10-15 min total; home NMES 2-3x/day until no quad lag; surgeon clearance assessments at CHOP sports PT locations at 3, 6, 9 months; CPM if available; return to sport 9 months; 10 deg/day flexion increase Phase I

Surgeon / Author

Dr. Theodore Ganley MD; Dr. Kathleen Maguire MD; Dr. Brendan Williams MD; Dr. J. Todd Lawrence MD PhD

Published

Revised 2023