REHABILITATION GUIDE
Rehabilitation after MPFL reconstruction.
Medial patellofemoral ligament (MPFL) reconstruction for kneecap instability. What to expect, stage by stage, with a printable copy to download.
MPFL reconstruction rebuilds the ligament that holds the kneecap in place, to stop it dislocating. The new ligament needs protecting while it heals into the bone. Your team will confirm the details of your programme, especially if other procedures were done at the same time.
At a glance
| Weight bearing | As advised by your team, usually with the knee held straight in the brace at first |
| Brace | Hinged knee brace for the early weeks |
| Knee bend | Movement from 0–90° to start with, increased as advised |
| Walking aids | Crutches for the early weeks |
| Normal daily function and sport | Around 6 months |
Your recovery, stage by stage
Protection phase Weeks 0–6
- Wear the brace as instructed and use crutches.
- Put weight through the leg as advised, with the brace locked straight unless told otherwise.
- Start gentle knee bending from 0° to 90° in the brace, as shown by your physiotherapist.
- Focus on getting the knee straight, controlling swelling and switching the thigh muscles back on.
Restoring movement and strength Weeks 6–12
- The brace and crutches are reduced with your physiotherapist’s guidance.
- Knee bend is gradually increased towards normal.
- Strengthening of the thigh, hip and core muscles, with balance and control work.
Progressive loading 3–6 months
- More demanding strengthening and, when advised, jogging and agility work.
- Return to normal function and sport is usually at around 6 months, once strength and control are restored.
Early exercises
- Ankle pumps
- Point your feet up and down briskly, 10–20 times every hour while awake. This helps circulation and reduces the risk of blood clots.
- Static quads
- Lying or sitting with the leg straight, tighten the muscle on the front of the thigh to push the back of the knee down. Hold 5 seconds, relax. Repeat 10 times.
- Straight leg raise (in brace)
- With the brace locked straight, tighten the thigh muscle and lift the leg about 15 cm. Hold 5 seconds. Repeat 10 times.
- Assisted knee bending (0–90°)
- Gently bend the knee within the range you have been allowed, then straighten.
- Buttock squeezes
- Squeeze your buttock muscles together, hold 5 seconds, relax. Repeat 10 times.
Looking after yourself
- Wound care
- Keep the dressing clean and dry. Stitches or clips are usually removed at around 10–14 days. Do not soak the wound in a bath, pool or hot tub until it has fully healed.
- Swelling
- Rest with the leg raised, and use an ice pack wrapped in a towel for 15–20 minutes several times a day. Swelling can last for weeks or months and is common.
- Pain relief
- Take your pain relief regularly in the early weeks, as prescribed, particularly before exercising. Reduce it gradually as the pain settles.
- Blood clot prevention
- Follow the hospital’s advice on blood-thinning medicine and stockings. Keep moving, do your ankle exercises, and drink plenty of fluids.
When to seek urgent help
Call 999 or go to A&E if you have chest pain, sudden breathlessness or cough up blood.
Contact the hospital where you had your operation straight away (or NHS 111 out of hours) if you have:
- Pain, swelling or tenderness in the calf
- The wound becomes red, hot or increasingly painful, or leaks fluid after the first few days
- A temperature above 38°C, shivering or feeling generally unwell
- A sudden increase in pain or swelling, or you cannot put weight on the leg as advised
- New numbness, tingling, coldness or weakness in the leg or foot
Sources
This guide is based on Mr Umar’s practice and is guided by NICE and British Orthopaedic Association (BOA) guidance:
Questions about your recovery?
| Spire Regency, Macclesfield | Denise Rowbotham · 01625 507472 |
| The Alexandra, Spire Manchester, Spire Hale and Circle Cheshire | Danielle Heron · 07528 523911 |
This is general guidance. Always follow the specific instructions from your own surgical and physiotherapy team, as your programme may differ.