This protocol is a general guide to MPFL rehabilitation. The time scales are an approximate guide and may be altered depending on various factors such as pain, swelling and muscle control. Pain along the MPFL graft site is relatively common for up to 4 months postoperatively and should not prevent participation in rehabilitation. The patient’s management should be tailored to meet individual objectives.
The MPFL is reconstructed using a hamstring graft. It is attached in the medial femoral condyle with a screw, there is a drill hole through the patella, and attached laterally with an endobutton.
Rehabilitation aims to protect the MPFL reconstruction in the early stages and to maximise the range of motion, strength and function.
Please check the post-operative notes for any variation in management.
Inflammatory stage. No initial blood supply to the graft.
Clinic review at 2/52 for removal of sutures and X-ray. The graft is at its weakest at 6/52.
The graft goes starts the process of revascularization and ligamentisation.
Exercises need to be tailored to their functional aim.
If they have had a long-term condition, they may have altered their movement patterns to accommodate. They need to be advised that rehabilitation could take 6–9/12 months.
X-ray plus outcome scores. By 3 months the graft fixation is consolidated. At 4 months there is complete revascularization of the graft, laying down of collagen and gradual increase in strength.
2/52, 12/52, 12/12