This procedure involves repair to the ligaments which stabilize your patella (medial patellofemoral ligament – MPFL repair), a transfer of the patellar tendon insertion point (tibial tuberosity transfer) inwards or a combination of the two, to address recurrent patellar dislocations. If the surgery has involved both procedures, this may prolong recovery time.
Phase one - The first phase of your recovery will be focused on managing your swelling and pain and allowing the MPFL repair/tibial tuberosity transfer to heal and strengthen. For this purpose, you will be placed in a knee brace which will be locked in to extension or allow only slight flexion of the knee for the initial two weeks after surgery. Thereafter, you will be allowed to gradually increase the knee range of motion until 6 weeks after surgery. Regular icing and compression of the knee is encouraged at this stage to bring down any swelling and bruising more rapidly. You will be provided with elbow crutches to help with balance and stability when weight bearing and walking.
If you have only had a MPFL repair, then we will encourage you to take full weight through the knee as your pain and strength allow. However, if there has been a tibial tuberosity transfer, your surgeon may ask you to take no significant weight through the operated leg for 6 weeks after surgery.
Your physiotherapist will guide you through some initial activation exercises for your quadriceps muscles which will help to support your knee and prevent excessive muscle wasting post-operatively.
Phase two - The second phase of your recovery will focus on enabling you to walk with a more normal gait pattern, increase your knee range of motion as quickly as possible and strengthen your hip and knee muscles. Under normal circumstances, you will be able to discard your knee brace at six weeks post-surgery. If you are still using elbow crutches at this stage due to having had a tibial tuberosity transfer, your physiotherapist will advise you how to start gradually increasing the weight you are taking on your operated leg. You will now be encouraged to start regularly stretching the knee in to flexion to regain full knee movement 12 weeks after post-surgery. Your physiotherapist will prescribe appropriate strengthening exercises involving resistance/loading exercises for the quadriceps muscles to stabilize and support your patella again. As your muscle strength improves, our physiotherapists will introduce some weight bearing exercises such as wall slides, squats and lunges.
Phase three - The third phase of your recovery will begin once you have enough strength and flexibility in your operated leg to start more complex movements and impact work. Typically, the initial part of this phase will involve commencing light impact work such as jogging on the treadmill and increasing the vigour of existing exercises such as squats, lunges and leg press. Your physiotherapist will guide you appropriately but under normal circumstances, once the strength of your operated leg is equal to your non-operated leg, activity or sports-specific rehabilitation exercises can be commenced. This may include progression to sprinting, jumping and rotational movements depending on the sport desired.
The Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill, Hydro Physio aqua-jogger, 3D Gait Analysis, sports exercise equipment such as the Concept2 rower, plus Circle’s Return to Sport Assessment Service may help rehabilitation following a patellar stabilization procedure