MPFL Reconstruction — Medial Patellofemoral Ligament (MPFL) Reconstruction

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Brace locked, PWB wks 0-1; WBAT with crutches per MD; walk without crutches when no increased pain/effusion/proper gait

Key Restrictions

Keep knee straight and elevated when sitting/lying — do NOT rest with towel under knee; TTO concomitant: different WB status and ROM per physician; flexion ≥90 deg Phase I goal; NMES with quad sets (2500 Hz, 75 bursts); return to sport: >80% functional assessment prior to return-to-run program

Timeline & Phases

6 phases: Phase I (0-2 wks, brace locked PWB then WBAT with crutches, full extension, flexion to 90 deg, quad sets with NMES, SLR), Phase II (3-6 wks, full flexion, normal gait, mini squats 0-60 deg, balance), Phase III (7-12 wks, elliptical/stair climber/pool at about 8 wks, gym strengthening), Phase IV (13-16 wks, bilateral to single-leg plyometrics, functional assessment >=80%), Phase V (3-5 months, return-to-run program, agility and plyometric program), Phase VI (6+ months, unrestricted return to sport, full play about 6-7 months)

Notes

Criterion-based; TTO variant addressed (stricter WB/ROM per physician); NMES protocol parameters specified; return-to-run program included (>80% functional assessment required before initiating); revised 11/2024; extensive references.

Surgeon / Author

MGH Sports Medicine