MPFL Reconstruction — / Tibial Tubercle Osteotomy / Trochleoplasty

University of Virginia Orthopaedic Surgery

Weight-Bearing

50% WB for 6 weeks (more conservative than MPFL alone)

Key Restrictions

50% WB for 6 weeks; no ambulation without brace first 6 weeks; brace 0-70° weeks 0-2, 0-90° weeks 2-4, unlock after week 4; avoid lateralization of patella; ROM 0-110° until week 8, 0-120° by week 10, full by 12 weeks

Timeline & Phases

Phase 1 (0-6 wks): 50% WB, brace 0-70° progressing to 0-90° then unlocked, quad sets/NMES, SLR 4-way, hamstring activation; Phase 2 (7-10 wks): normalize gait, ROM 0-110° to 0-120° to full, leg press (bilateral), FSU, stationary bike short crank progressing as ROM allows; Phase 3 (11-18+ wks): full ROM by 12 wks, running initiation, bilateral plyometrics; Phase 4 (19-24 wks): advanced strengthening, cutting with MD clearance; Criteria: 85% LSI isokinetics, hop test >85%

Notes

Combined MPFL + TTO + Trochleoplasty; more conservative than MPFL alone: 50% WB for 6 weeks (vs. 4 weeks), brace starts at 0-70° (vs. 0-90°); stationary bike uses short crank progressing to standard crank (needs 115° flexion sitting); full ROM target by 12 weeks; same discharge criteria as MPFL alone

Published

12/2024