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Rehabilitation Protocols Following Patellar Instability Surgery: A Structured Review of Published Recommendations and
Matias Vidra1,2, Jonathan Sigal3, Ilan Y Mitchnik2,4
1Sports Injuries Division and Joint Preservation Center, Tel Aviv Sourasky University Medical Center (Ichilov), Tel Aviv, Israel.
Current Reviews in Musculoskeletal Medicine
|June 8, 2026
Summary
Post-surgery rehabilitation for patellar instability varies greatly, especially for procedures other than medial patellofemoral ligament reconstruction (MPFLR). AI tools can assist, but clinical judgment is key for personalized patient recovery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Rehabilitation Science
Background:
- Patellar instability requires tailored postoperative rehabilitation.
- Current protocols lack standardization, particularly for complex procedures.
- Artificial intelligence (AI) offers potential for protocol development.
Purpose of the Study:
- To review and compare postoperative rehabilitation protocols for patellar instability surgery.
- Include medial patellofemoral ligament reconstruction (MPFLR), tibial tubercle osteotomy (TTO), trochleoplasty, and combined procedures.
- Evaluate AI-generated rehabilitation guidance against published recommendations.
Main Methods:
- Systematic review of 63 rehabilitation protocol entries.
- Categorization by surgical procedure: isolated MPFLR, TTO, trochleoplasty, and combined.
- Comparison of AI-generated protocols with existing literature.
Main Results:
- MPFLR protocols showed consistency: early weight-bearing, bracing up to 6 weeks, and full ROM by 12 weeks.
- TTO and trochleoplasty protocols were less defined and more conservative.
- Return-to-sport (RTS) criteria focused on time, function, and strength, underutilizing psychological readiness.
Conclusions:
- Patellar instability surgery rehabilitation protocols are highly variable, especially for non-MPFLR procedures.
- MPFLR protocols are more structured; TTO and trochleoplasty require clearer guidelines.
- AI can support, but clinical expertise is essential for integrating rehabilitation strategies and RTS decisions.