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 Patella Dislocation Stabilization Surgery Rehabilitation (MPFL)

Phase I (0-6 weeks)


  • Home exercise program will begin after surgery – 2 weeks

  • 1-3x/wk. from 2-6 wks.

Rehabilitation Goals

  • Protection of the post-surgical knee

  • Restore normal knee range of motion.

  • Normalize gait.

  • Incisions healed and effusion decreased.

  • Restore leg control.


  • Brace locked in extension for gait and activities of daily living.

  • Crutches for gait as needed with brace on, weight bearing as


  • Range of motion limited to 0-90 degrees.

Suggested Therapeutic Exercise

  • Quadriceps sets.

  • SLR 4 way with brace.

  • Ankle pumps.

  • Ankle isotonic exercises.

  • Continuous Passive Motion Device as tolerated 0-90 degrees,

    advance as tolerated within this range.

Cardiovascular exercise

• Upper body circuit training or upper body ergometer (UBE).

Progression Criteria

• Postoperative 6 weeks.


Phase II (weeks 6-12)


• Rehabilitation appointments are 1-3 times per week.

Rehabilitation Goals

  • Single leg stand control.

  • Good control and no pain with short arc functional


  • Good quad control.

  • Normalize gait brace unlocked.


• Avoid over stressing fixation: begin movement control and gentle strengthening with closed chain movement in a shallow arc of motion and by using non-weighted techniques.

• Avoid post activity swelling.

Suggested Therapeutic Exercise

  • Gait drills.

  • Functional single plane closed chain movements.

  • Continued gradual progress of range of motion.

  • Gradual progress of lower extremity strengthening with

    precautions to avoid dynamic valgus or medial knee


  • Balance and proprioception exercises.

  • CPM as needed.

Cardiovascular exercise

• Upper body circuit training or UBE.

Progression Criteria

  • Normal gait on level surfaces.

  • Good leg control without extensor lag, pain or apprehension.

  • Single leg balance greater than 15 seconds.

  • At least 12 weeks postoperative.


Phase III (week 12-16)


• Rehabilitation appointments 1-3xwk.

Rehabilitation Goals

  • Full range of motion.

  • No effusion.

  • Improve quadriceps strength.

  • Improve proximal hip and core strength.

  • Improve balance and proprioception.


  • Avoid closed chain exercises past 90 degrees of flexion to avoid overstressing the repaired tissues and increased patellofemoral forces.

  • Avoid post-activity swelling.

Suggested Therapeutic exercises

  • Continue range of motion exercises and stationary bike.

  • Closed chain strengthening begin with single plan with

    progression to multi-plane.

  • Single leg press.

  • Balance and proprioception exercises.

  • Hip and core strengthening and stretching.

  • Initiate low amplitude agility drill in the sagittal plane, avoid

    frontal and transverse initially due to potential for dynamic valgus.

Cardiovascular exercise

  • Swimming with flutter kick, stair stepper.


Progression Criteria

  • Full range of motion.

  • No effusion.

  • No patellar apprehension.

  • Single leg balance with 30 degrees of flexion greater than 15


  • Good control and no pain with squats and lunges.


Phase IV (months 4-6)


• Rehabilitation appointments 1-3xwk.

Rehabilitation Goals

• Good eccentric and concentric multi-plane dynamic. neuromuscular control (including impact) to all for return to work/sports.


  • Post activity soreness should resolve within 24 hours.

  • Avoid post-activity swelling and pain.

Suggested Therapeutic exercises

  • Impact control exercises with progression from 2 feet to 1.

  • Movement control exercises with progression.

  • Progression to multi-planar agility drills with progressive.

    increase in velocity and amplitude.

  • Sport/work specific balance and proprioceptive drills.

  • Hip and core strengthening.

  • Stretching for patient specific muscle imbalances.

Cardiovascular exercise

• Replicate sport or work specific energy demands.

Return to work/sport

  • Dynamic neuromuscular control with multi-plane activities and without pain, instability or swelling.

  • Approval from the physician and/or sports rehabilitation provider.

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