Rehabilitation after Medial Patella Femoral Ligament (MPFL) Reconstruction

After your child’s medial patella femoral ligament reconstruction surgery, rehabilitation is key to getting back to a normal life. After surgery, your child will continue to meet with your doctor and other specialists, but will work most closely with a physical therapist during rehabilitation. Every child’s rehabilitation process is different, but often your child will meet with the physical therapist several times a week, then be expected to do exercises at home, too. The section below gives you a better understanding of the rehabilitation process. It’s important to work closely with your child’s specialists and physical therapist to ensure that rehabilitation is going as planned so your child can safely return to their normal activities.

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0-1 Week

During the first week after surgery, your child’s care team will work with you and your child to help ensure they attain the certain goals and perform specific exercises:

• Use of a locked brace
• Basic range of motion (ROM) exercises, performed with the brace on
• Discontinued use of crutches at 1 week

2-4 Weeks

During weeks 2-4, goals and exercises will include:

• Use of a locked brace
• Ability to flex the knee to 90 degrees
• 0 of knee extension ROM
• No active open chair quad activation
• Progression of knee flexion ROM by 10-15 per week
• LE strength and endurance exercises for quads, hamstrings, gastroc/soleous and gluteals

4-6 Weeks

By 4-6 weeks after surgery, your child should be able to perform more challenging exercises. Here is what you can expect at this point in your child’s rehabilitation:

• Use of brace but unlocked to allow for full knee flexion ROM
• Should have approximately 130 of knee flexion by this point
• Progressions of knee flexion ROM by 10-15 per week
• LE strength and endurance exercises for quads, hamstrings, and gastroc/soleous and gluteals

6-10 Weeks

During this rehabilitation phase, your child will no longer need a brace and exercises will continue to gain intensity. Here are some things you can expect

• Discontinue use of brace after 10 weeks post surgical
• Should have approximately 150 of knee flexion by this point (equal of opposing side)
• Progression of knee flexion ROM by 10-15 per week
• LE strength and endurance exercises for quads, hamstrings, gastroc/soleous and gluteals

10-12 Weeks

During weeks 10-12, your child’s physical therapist will help them continue to gain strength in the leg and knee:

• LE strength and endurance for quads, hamstrings, gastroc/soleous and gluteals

12-20 Weeks

As your child nears the end of their rehabilitation, they’ll begin to incorporate more intense exercises as they increase their strength. These exercises include:

• LE strength and endurance exercises for quads, hamstrings, gastroc/soleous and gluteals
• Begin open chain quads at 12 weeks
• Begin progression of plyometric exercises at week 12
• Isokinetic strength testing and functional strength (hop test of Star excursion test) test at 20 weeks post surgical

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