The tibial tubercle is usually moved medially and anteriorly to improve the ‘Q’ angle and patella tracking. The strength of fixation of the transferred tibial tubercle will shape the surgeon’s decision on whether or not a splint is required post operatively.
- Elevation of the limb
- Isometric quadriceps – V.M.O. especially
- Muscle pump exercises
- P.W.B. (in cricket splint as necessary)
- Gentle R.O.M. exercises
- Patella mobilisation
Progress to include:
- Hamstring exercises.
- Gradually increase range of movement but do not force.
- Remain P.W.B. if not in a splint.
- May be able to FWB if in a cricket splint.
(Some protection required – crutches or splint – to prevent giving way or sudden strong quadriceps contraction).
- Progress to F.W.B. and abandon splint
- Begin graduated quadriceps strengthening
- CKC activity and proprioceptive training
- Stretching all muscle groups
- Full range hamstring contractions
CONDITIONS FOR DISCHARGE
- Pain free
- No swelling
- Full function
- Improved timing of VMO