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Patella Stabilisation
RECOVERY AND RISKS
Patella stabilisation is a broad term to describe surgery that is used to stabilise (prevent dislocation) of the kneecap (patella). There are many options for this type of surgery, which can include both bone and soft tissue procedures or a combination of both. Your risks and recovery are different depending upon what exactly has been done. It is essential your rehabilitation regime is supervised by a knowledgeable physiotherapist.
Soft Tissue Surgery: MPFL Reconstruction and Other procedures
Recovery After Surgery
Week 0-2: Rest + Recovery
The aims of this period are to:
- Reduce Swelling: Brace, Elevate and Compress
- Control Pain
- Straighten the knee, and start gently bending the knee (passive)
- Activate Quads (Quads sets) + Straight Leg raise
You will be on crutches for this period, but you can fully weight bear. It is essential to be reviewed at 2 weeks to check your incisions and healing.
Week 2-6: Early Rehabilitation
Goals:
- Restore Range of Motion
- Control Swelling
- Balance Control
- Quads Control
Exercises(example only): stationary bike (start with the seat up high and slowly reduce), swimming with pool buoy between knees, walking without crutches
Week 6-12: Mid Rehabilitation
Goals: progress strength, balance, proprioception (+ taping), begin light impact work
- Balance, ROM, Strength
- Road cycling
- Begin straight line jogging
Week 12+: Sport Specific Retraining
Begin sport specific training, jogging, cutting activity
Bone Surgery: Tibial Tubercle Osteotomy
Recovery After Surgery
The rehabilitation and recovery after Tibial Tuberosity Osteotomy is similar to that of soft tissue surgery described above, except that the knee will be placed in a hinged knee brace for the first 6 weeks.
For the first two weeks the brace will be locked in extension for walking, sleeping, and activities of daily living. Full weight bearing with brace on. It can be unlocked from 0-90 for range of motion activities for the first two weeks, then 0-120degrees from 2-6 weeks. There should be no active knee extension for the first 6 weeks.
At the 6 week review, if X rays show the bone healing, then the brace can be weaned off.
Risks of Surgery
There are general risks of any surgery, and risks specific to patella stabilisation procedures (not limited to):
General risks of any surgery:
- Risks of anaesthetics
- Risk of infection (<1%)
- Risk of scarring
- Blood Clots (DVT)
Specific risks of Patella Stabilisation Surgery:
- Recurrent Instability/Dislocation (1-2%)
- Prominence of screws/need for metalware to be removed
- Stiffness
- Arthritis
- Numbness (related to incisions around the knee)
- Fractures
- Bones not healing (non-union)
- Need for revision surgery