How to Prepare for an MPFL Reconstruction

Medically reviewed by Dr. Sabrina Strickland, MD · Orthopedic Surgeon, Hospital for Special Surgery · Last reviewed: May 2, 2026

Quick Summary

Preparing for an MPFL reconstruction mostly comes down to two situations: acute dislocation that may need urgent surgery, or chronic instability where you have weeks to plan. For elective cases I recommend 4–6 weeks of prehab focused on quad, hip, and core strength, full range of motion, a clear medication and supplement review, and a plan for transportation and home support. Knowing what to expect at each stage reduces stress and supports a smoother recovery.

October 9, 2025

Understanding what to expect and how to prepare for an MPFL reconstruction empowers you through each stage, minimizing stress and improving outcomes.

There are essentially two categories of patients who undergo an MPFL reconstruction or related surgery.

Acute Dislocation with an Osteochondral Fragment

There are those patients who have an acute dislocation with an osteochondral fragment (a piece of cartilage off), and in these cases, it’s fairly urgent to take them to the operating room as often their knee is locked and they have difficulty weight-bearing. (This surgery may involve fragment fixation/removal, and not always require an MPFL reconstruction.)

In these cases, it’s best to manage pain and swelling and try to get to the operating room as soon as possible. If possible, you may do gentle quad sets and gentle range of motion activities. Stay off the affected leg, use crutches as directed, and apply ice to help minimize swelling. Always notify your care team if you experience increasing pain, fevers, or new symptoms.

Chronic Instability

In patients with chronic instability (the primary group for elective MPFL reconstruction), preparation is key to a smoother surgery and recovery. Ideally, you prepare for surgery by:

Finding a good physical therapist who you trust and enjoy working with.
Familiarizing yourself with the planned rehab protocol.
Doing a home exercise program to ensure that you have full range of motion and good quad and hip strength.

Proactive “prehab” with your physical therapist, focusing on building quadriceps, hip, and core strength, may shorten your post-op recovery and reduce risk of stiffness. I recommend finding physical therapists with expertise in knees or sports medicine. Ask about their experience with MPFL reconstruction to ensure optimal guidance and care, both before and after surgery.

Additional Steps to Prepare for an MPFL Reconstruction

Medical Evaluation and Imaging

Before surgery, ensure all required preoperative imaging (MRI or X-rays) is complete so your provider can assess your injury accurately and identify any complicating factors. Bring any images to the surgical center, or confirm that they’ve been uploaded in advance.
Learn more about knee imaging from AAOS

Medication and Supplement Review

Discuss your current medications and supplements with your orthopedic surgeon. You may need to stop taking some drugs, including anti-inflammatories and blood thinners, before your procedure. Bring an up-to-date medication list to your pre-op visit.
Hospital for Special Surgery: Preparing for Surgery

Plan for Postoperative Support

Arrange transportation to and from the hospital and prepare your home for limited mobility. Store essentials at an accessible height, clear walkways, and consider a firm chair for easy sitting and standing. Enlist help from family or friends to assist with meals, errands, or childcare during the first week after surgery.
OrthoInfo: Recovery after Surgery

Local Physical Therapy Resources

Find a PT clinic specializing in sports medicine or knee rehab.
ChoosePT may help you find one near you.

Pre-Surgery Checklist Download

Use a checklist to keep track of appointments, medications, and home prep.
Download helpful guides and forms.

Pre-Op Exercise Videos

Follow instructional videos for quad sets, hip strengthening, and gentle range-of-motion work to maximize your knee’s readiness.
HSS Knee Exercise Library

Practical Day-of and Pre-Op Visit Tips

On surgery day, wear loose clothes and bring identification, insurance details, and your medication list. For appointments, consider a notebook for instructions and questions.

For more information, read how long MPFL recovery takes and this overview of MPFL reconstruction surgery.

Make Sure You Prepare for an MPFL Construction

Although knee surgery and recovery can be challenging, if you take the time to prepare for an MPFL reconstruction and and are committed to open communication with your healthcare team, you will be set up for the best possible outcome. Please reach out if you would like to schedule a surgical consultation or get a second opinion. With the right support and resources, a full return to activity is an attainable goal.

Hear from one of my patients about his MPFL reconstruction:

https://www.youtube.com/watch?v=BsLj88MDWlU

Photo by Imani Bahati on Unsplash

acute dislocation, chronic instability, knee surgery, medical evaluation, MPFL reconstruction, osteochondral fragment, patellar dislocation, Physical Therapy, postoperative support, pre-op preparation, Prehab, quad strength, range of motion, rehab protocol

Frequently Asked Questions

How early should I start prehab before an MPFL reconstruction?

For elective MPFL reconstruction in patients with chronic instability, I recommend starting prehab (the strengthening and motion work you do before surgery) at least 4 to 6 weeks before the operation. The goals are full pain-free range of motion, a strong quad, and good hip and core control. Patients who arrive at surgery with a quiet knee and active quads tend to regain motion and strength faster after the operation.

What is the difference between an acute and chronic MPFL situation?

An acute case usually involves a recent dislocation, sometimes with a loose piece of cartilage and bone in the joint, a swollen knee, and difficulty putting weight on the leg. These patients often need urgent imaging and may go to the operating room sooner. A chronic case involves repeated dislocations or instability over months or years — that's the typical setting for an elective MPFL reconstruction with planned prehab.

What medications usually need to be stopped before MPFL reconstruction?

Many anti-inflammatories, blood thinners, and certain supplements increase bleeding risk and may need to be paused before surgery. The exact list and timing depend on your overall medical history and what your surgeon and primary care team recommend. Always bring an up-to-date medication and supplement list to your pre-op visit so the team can make a clear plan with you.

What should I have at home before an MPFL reconstruction?

Plan for limited mobility in the first week. Helpful items include crutches or a walker as directed, ice or a cold-therapy unit, a firm chair that's easy to sit and stand from, clear walkways, and essentials stored at counter height. Arrange transportation home and ask a family member or friend to help with meals and errands during the first several days.

Are there risks I should be aware of with MPFL reconstruction?

As with any knee surgery, MPFL reconstruction carries risks including infection, bleeding, blood clots, stiffness, the kneecap dislocating again, and graft-related complications. Outcomes are generally good in well-selected patients, but results depend on your individual anatomy, how consistently you stick with rehab, and your overall health. We discuss your specific risk factors at the pre-op visit so expectations are realistic.