knee- patellofemoral- medial patellofemoral ligament reconstruction
This document provides a detailed, phase‑based postoperative rehabilitation protocol for patients who have undergone medial patellofemoral ligament (MPFL) reconstruction. It is organized into five sequential phases: (I) Immediate Post‑Operative (Days 1‑5), (II) Acute (Weeks 2‑4), (III) Sub‑Acute “Motion” (Weeks 5‑8), (IV) Strengthening (Weeks 9‑16), and (V) Return‑to‑Activity. For each phase the protocol lists specific goals (e.g., swelling control, quadriceps activation, ROM milestones), brace and weight‑bearing instructions, swelling‑management strategies (cryotherapy, compression, elevation), prescribed range‑of‑motion limits, muscle‑retraining and strengthening exercises (quadriceps isometrics, straight‑leg raises, hip adduction/abduction, leg press, squats, lunges, bicycle, pool program), flexibility routines, and explicit criteria required to progress to the next phase (minimum ROM, absence of swelling, voluntary quad control, strength ≥80% of the contralateral limb, satisfactory clinical exam). The document also references specific patellofemoral brace models and emphasizes continued use of a PF brace during later phases. Copyright notices are included but are not part of the clinical content.
Topics
Immediate Post‑Operative Phase (Day 1‑5): Foundations of Healing
Outlines early goals (swelling, pain, quad activation, independent ambulation), brace locked in full extension, partial weight‑bearing with crutches, swelling control methods, limited ROM (0‑30° flexion), muscle‑retraining (quad isometrics, straight‑leg raises, hip adduction, EMS), and basic flexibility work.
Acute Phase (Weeks 2‑4): Controlled Progression of Mobility and Strength
Describes transition from brace for ambulation to discontinuation, weight‑bearing progression, ROM targets (0‑60° by week 2, up to 0‑90° by week 4), continued swelling management, patella mobilizations, expanded muscle‑retraining (EMS, quad isometrics, straight‑leg raises, hip adduction/abduction, gentle sub‑maximal knee extension), and introduction of light leg press and vertical squats.
Sub‑Acute “Motion” Phase (Weeks 5‑8): Expanding ROM and Endurance
Focuses on gradual ROM increase to 0‑125/135°, reduction of crutches, continued PF brace use, advanced exercises (vertical squats, leg press, light knee extensions, bicycle, pool walking/strengthening), and ongoing flexibility and patella mobilizations.
Strengthening Phase (Weeks 9‑16): Building Functional Muscle Capacity
Sets criteria for entry (≥115° ROM, no swelling, quad control), outlines strength‑focused exercises (vertical/wall squats, leg press, forward/lateral lunges, step‑ups, knee extensions, hip adduction/abduction, bicycle, stairmaster), and emphasizes functional activity drills.