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); no lateral patellar mobilizations; avoid dynamic knee valgus and femoral IR throughout; return to sport: >80% functional assessment prior to return-to-run program

Timeline & Phases

5 phases: Phase I (0-2 wks, brace locked PWB → WBAT, PROM flex ≥90 goal, quad sets + NMES, SLR), Phase II (2-6 wks, WBAT → FWB, progress flex full, bike wk 4, progressive strengthening), Phase III (6-10 wks, D/C brace, normalized gait, begin CKC), Phase IV (10-16 wks, advanced strengthening, jogging if criteria met), Phase V (4-6+ months, return to sport, plyometrics)

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); no lateral patellar mobs; extensive references. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-02-28.]

Surgeon / Author

MGH Sports Medicine