Trochleoplasty with MPFL Reconstruction — and Lateral Retinaculum Lengthening

Mammoth Orthopedic Institute / Sierra Park PT · Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Julie Perumal…

Weight-Bearing

WBAT with crutches x2 weeks (brace locked 0 deg); brace unlocked for gait with good quad control from wk 2; wean crutches as tolerated

Key Restrictions

Brace locked 0 deg x2 weeks; no CKC exercises x6 weeks; full AROM goal by 6 weeks (must reach 90 deg by wk 4 or contact MD); patellar crepitus normal up to 8 weeks; swelling expected up to 3 months; light impact from 8-12 weeks pain free

Timeline & Phases

4 phases: Phase I (0-2 wks, WBAT brace locked 0 deg, quad sets, open chain hip, bike for ROM), Phase II (2-6 wks, brace unlocked for gait, open chain strength with resistance, no CKC, full AROM by wk 6), Phase III (6-12 wks, CKC bilateral to SL, eccentric quad with LE alignment, light impact 8-12 wks), Phase IV (12-24 wks, multi-plane, plyometrics, running progression, RTS test)

Notes

References Connecticut Children's Medical Center ELITE Sports Medicine; no CKC x6 weeks distinguishes from standalone MPFL protocol; crepitus normal up to 8 weeks; swelling expected up to 3 months; Julie Perumal PT 12/31/20; Gilmer MD 2/10/21

Surgeon / Author

Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Julie Perumal PT

Published

February 2021