MPFL (Medial Patellofemoral Ligament) & TTO (Tibial Tubercle Osteotomy) Protocol
0-6 Weeks Post Op
- Non weight bearing x 6weeks
- Edema reduction- modalities as needed
- Quad sets/SLR in Brace at 0° (assist patient with this exercise until solid quad contraction developed)
- Banded calf pumps/ calf stretches
- BFR- Initiate at post op day 14
6-12 Weeks Post Op
- Continue as above
- Discontinue post operative brace at 6 weeks post op- use situationally as needed over weeks 7 and 8
- Begin two week weight bearing transition at 6 weeks after in office radiographs and clearance by physician
- Use two crutches over week 7 and then transition down to one crutch for week 8
- Normalize gait mechanics
- Stationary Bike to increase ROM, start with high seat and progress to normal height when able, resistance as tolerated
- Begin weight bearing strengthening once off assisted devices
- Leg press, squats, lunges, step ups, RDL, etc (in progressive fashion)
- DL to SL balance progression
12-24 Weeks Post Op
- Continue to progress strengthening as tolerated
- May begin non- impact cardio exercises- swimming, cycling, rowing, elliptical
- Impact activities can begin between 3-6 months depending on radiographic healing as determined by the physician
- Return to running transition
24+ Weeks Post Op
- Transition into more power focused strengthening to prepare for return to sport
- Initiate plyometric program as appropriate to patient’s functional goals
- Initiate sport specific activities under supervision by ATC or PT
- Clearance by physician prior to return to sport