Hi all,
I am currently completing my musculo placement and I have a new patient next week 3/12 post patella tendon rupture and surgical repair. I have been unable to source any info from the patient's notes as of yet and thus do not have much information about the surgical procedure and subsequent treatment protocol and contraindications.
Just guessing, but at 3 months I would think you would be into the 3rd stage of treatment, so one would be starting to strengthen the quads, hamstrings and gastroc around the knee in weight bearing positions, and begin proprioception work. Stage 1 (the first 6 weeks) would be all about controlling inflammation and mininmising scar tissue, bracing and passive mobilisation. Stage 2 (weeks 6-12) would be about improving ROM and maybe some strengthening in non-weight bearing positions.
Therefore I was wondering if any of the crew have treated such a patient on there musculo placement (or can remember any details from there ortho placement last year) and can shed some light on the subject for me.
Cheers
Nico
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2 comments:
Hey Nic,
That sounds like some really good treatment ideas. In terms of other treatment options protocols I think it would be a really good idea to ask your supervisor as no doubt they will have seen this type of injury before. Also setting goals with the patient will help you determine appropriate treatment strategies.
The other thing you need to consider is your assessment, as the old saying goes ‘assessment determines treatment’. If this is the first time your patient has come to physiotherapy then it is highly unlikely they have been doing any exercises or received any treatment to the knee.
Therefore they may still be in stage 1-2 of the treatment program. If this is the case you will probably also need to be treating any other areas that may be deconditioned. Don’t forget about the hip to as this also has an important part of the gait cycle.
Cheers
Swan, good thoughts.
To them I would add:
The type of repair / surgeon's orders may help guide... I am assuming the operation rarely if ever involves grafting in tissue from elsewhere, but if it did, there is that critical period of minimum strength at roughly 5-12 weeks before neovascularization is complete (a la ACL repair).
Finally, I will put you in touch with JB. She is a physio who severed 95% of her patellar tendon during her studies at Curtin and rehabbed with the help of a good physio and input from her prof.s.
Check your email.
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