Begin multi-plane straight leg raising and closed kinetic chain strengthening program focusing The graft is precisely placed in the [], Download as PDF Information The following is the Steadman Hawkins Denver Clinic preoperative protocol. % Hoorntje A, Kuijer PFM, van Ginneken BT, et al. bA'e J\FR0yn^J:Lw,\g`&2L4lL-ux? Park City, Utah 84060 endobj Use only as directed. endobj The main emphasis focuses on: Reducing inflammation Restoring full range of motion Restoring quadriceps function Phase I Inflammatory Phase: Modalities to control inflammation Prescription anti-inflammatories Ice Clinical modalities to control inflammation Cardiovascular Exercises Stationary bike-focus on restoring range of motion Pool program as [], Download as PDF Phase I Maximum Protection (Weeks 0 to 4): 0 to 1 Week: Brace locked in full extension for 4 weeks Use crutches for 7 to 10 days to reduce inflammation, then weight bearing as tolerated Ice and modalities to reduce inflammation and pain Range of Motion 0 of knee extension 90 [], Download as PDF Phase I Maximum Protection (Week 0 to 1): Ice and modalities as needed to reduce pain and inflammation Use crutches for 2 to 5 days to help reduce swelling, the patient may discontinue crutches when able to walk without a limp or pain Elevate the knee above the heart for the [], Download as PDF Phase I Maximum Protection (0 to 1 week): Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills CPM x 6 weeks Full passive/active knee range of motion exercises [], Download as PDF Phase I Maximum Protection (0 to 1 week): Ice and modalities to reduce pain and inflammation Brace 0 to 20 for 6 weeks Use crutches (approx. Sports Med Arthrosc Rev 2017;25:105-113. ORIF TIBIAL TUBERCLE PROTOCOL I. Rehabilitation should create the optimal environment for the natural process of healing to occur. Murray, Utah 84107 Clark D, Walmsley K, Schranz P, et Neuromuscular control and co-ordination of leg, Return to running in sensible progressive time frame, Resisted quads and hamstring weight training, Double calf raises progress to single calf raise, Exercycle increase resistance and training length. ~?s~4or\E2~/~G0}"/"nn/~|k-{2?fQL(ENd"*@kYO *COLE,*MD,*MBA WEIGHT BEARING BRACE** ROM EXERCISES PHASE I 0-2 weeks Full in Brace locked in extension* Locked in full extension for sleeping and all activity* Off for exercises and hygiene 0-90 when /Z@-+P-EJBKp4M+U, +qYB8K9zLcErC %PDF-1.5 Tibial Tuberosity Osteotomy Rehabilitation Protocol Description of Procedure: Tibial tuberosity osteotomy (TTO) involves a cut of the tibial tuberosity, effecting centralization of The patient may discontinue the crutches when they can ambulate with no limp Range of Motion Patella mobility Emphasize full extension (avoid hyperextension x 4-6 [], Download as PDF Phase I Maximum Protection (Weeks 0 to 2) Brace six weeks Use crutches weight bearing as tolerated for 7 to 10 days to reduce swelling. There is increased interest in the surgical technique secondary to cartilage repair procedures failing in the setting of malalignment of the lower extremity. High tibial osteotomy decreases knee pain, allows higher activity levels post operatively and much improved quality of life2. Vol; 26 (10), pp 1384 Please refer to the following protocol to guide your rehabilitation after your tibial plateau fracture. endobj PCL Rehabilitation Protocol. 1 0 obj The outcomes of the modified Fulkerson osteotomy procedure to treat habitual patellar dislocation associated with high-grade trochlear dysplasia. endobj 5 0 obj WebRehabilitation Guidelines. It involves removing a small piece of bone on the front of the shin bone and reattaching it with anchors or screws to a different position. Continue with swelling control and patellar mobility. <> Your experiences may differ from those described. 4 Weeks Transition to full weight-bearing Brace [], Download as PDF Bracing Brace locked at 20 for the first 4 weeks Remove brace under PT supervision for passive extension ROM. Please note this protocol is a guideline. All exercises must be demonstrated to a patient by a fully qualified Physiotherapist. <> endobj Tibial tuberosity transfer in combination with medial patellofemoral ligament reconstruction: Surgical technique. <> p# w: +0^ k HFkMTXVrbB!E&`;r;{Q ~^^\Uu]0q[ZOZSTUk>R5E+v[APD] If your surgery date is beyond that time frame, [], 900 Round Valley Drive, Suite 100 endobj Contact. Progression is both criteria-based and patient specific. endobj The patient may discontinue the crutches when they can ambulate with no limp Range of Motion goal Patella mobility 90 100 of knee [], Download as PDF Phase I Maximum Protection (0 to 2 weeks): Weeks 0 to 2: Lateral buttress in post-op dressing to stabilize patella Ice and modalities to reduce pain and inflammation Use crutches for 5 to 7 days to reduce swelling. 9B\vedQ o2O#.W Y$%:LkzpiW^MSQSCVtv!IMj/2i+&$anlS_Pjii]*, 8-bo'wE.xl].Qt,mW)Sd:C:gvN\9f R30wt@X` a0(aR0B09!\NIntuxL9&u&s(d0#$5 1a`7H>8301gf^jsd42Z.Pd)kYT$]ax w0F1v YAri`+Ljlbq WebThe tibial tubercle is the bony bump on the front of your leg where the tendon from the patella (knee cap) inserts. cC}W\+:`~#^h[?m.`^lsTxM%zj~Zwy8 5I8Y*WXCAn`lxIUmU}y0n1~q!T)`\58=|[nq^l <> The semitendinosus (hamstring) graft is utilized because of its excellent strength and low harvest morbidity. stream Heber, Utah 84032, 5848 S Fashion Blvd (300 E) In tibial tubercle osteotomy surgery (also called tibial tubercle transfer) this tuberosity, with the tendon attached, is cut and shifted. Tibial Tubercle Transfer Post-Operative Protocol. More 781-429-7700 team@ortho.boston. endobj Fax: 435-655-2388 This can offload the painful portion of the patella or can increase !rtrLf;N 8PrCf7 #}:Ro2s:y1!dA1A BMC Hara M, et al. WebPost-operative Rehabilitation Protocol Medial Patellofemoral Ligament (MPFL) Reconstruction / Tibial Tubercle Osteotomy (TTO) / Trochleoplasty . Do [], Download as PDF ____Arthroscopic Abrasion Chondroplasty ____Arthroscopic Debridement ____Arthroscopic Meniscectomy ____Arthroscopic Synovectomy Diet Begin with liquids and light foods (jellos, soups, etc.). WebThe surgeon then uses a bone-cutting instrument to cut the tibial tubercle (to which the patellar tendon attaches) so that the bone and patellar tendon can be moved medially or toward the inside of the knee. Lippincott Williams & Wilkins Inc. 2007; 6(2): 88-92. Ice and modalities to reduce pain and inflammation Patella and patella tendon mobility drills Range of motion [], Download as PDF Phase I Inflammatory Phase: Modalities to control inflammation Prescription anti-inflammatories Ice Clinical modalities as needed Evaluate and treat lumbar, sacral, and pelvic dysfunction Evaluate for corrective orthotics Implement appropriate, selective stretching Iliotibial band Hamstrings Quadriceps Gastrocnemius/soleus Piriformis Apply appropriate patella mobilizations Evaluate lateral retinaculum and apply patellar tilt mobilization when indicated [], Isolated PCL Injury Rehabilitation conservative treatment PHASE I WEEK 1-2 PHASE II WEEK 3-6 PHASE III WEEK 7-12 PHASE IV > MONTH 3 Weight Bearing PWB (20% flat foot) Symptomatic control WBAT WBAT FWB Brace Rebound PCL Day & night (within 4 weeks of Injury) grey shear knob Rebound PCL (day & night; grey [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella mobility drills Range of motion 0 to 30knee flexion Begin submaximal quadriceps setting Weeks [], Phase I Maximum Protection (0 to 1 weeks): 0 to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Brace for 6 weeks in full extension Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills Begin full passive/active [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Non-weight bearing for 4-6 weeks per physicians instructions Ice and modalities to reduce pain and inflammation Aggressive patellar mobility drills Range of motion 0 to 45knee flexion Begin submaximal quadriceps [], Download as PDF ____Arthroscopic Ligament Procedures ____Arthroscopic Lateral Release ____Proximal Distal Realignment ____High Tibial Osteotomy ____Meniscal Repair Diet Begin with liquids and light foods (jellos, soups, etc.). Gain in confidence during athletic activity. Effectiveness of an Accelerated Rehabilitation Protocol After Tibial Tubercle Osteotomy. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling JFIF ` ` C Do not combine with alcoholic beverages. TIBIAL TUBEROSITY TRANSFER PROTOCOL PHASE 4 patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy, Arthroscopy. <> WebKNEE TIBIAL TUBERCLE TRANSFER POST-OPERATIVE GUIDELINES The following tibial tubercle transfer (TTT)/ tibial tubercle osteotomy (TTO) guidelines were developed HSS Rehabilitation. Open brace to 45- 60 of flexion week 6, 90 at week 7. Tibial tubercle osteotomy (TTO) is one of the many procedures utilized in the treatment of recurrent patellar instability, painful extensor mechanism maltracking, and patellofemoral chondrosis, alongside a concomitant cartilage procedure in patients who fail nonoperative treatment options. WebPost-Operative Rehabilitation Protocol Tibial Tubercle Osteotomy PHASE 1 - ACUTE (0-6 Weeks) PHASE GOALS: PROTECT OSTEOTOMY, RESTORE QUADRICEPS ACTIVATION RANGE OF MOTION 0-1 WEEKS - ALLOW FLEXION TO 30 DEG 1-2 WEEKS - GRADUALLY PROGRESS FLEXION TO 60 DEG $.' Emsculpt. A tibial osteotomy is performed when only one side of your knee shows damage. WebTIBIAL TUBERCLE EXCISION (OSGOODE-SCHLATTER) REHABILITATION PROTOCOL ! Please note that this is advisory information only. 4 0 obj The time scales are an approximate guide and may be altered depending on various factors such as pain, swelling and muscle control. endobj The tubercle is held in its new position with 2 screws made of stainless steel. 2 0 obj Phases and time frames are designed to give the clinician a general sense of progression. z&VZ*_6{@z =6,a0+ qp^v u]z4 ZXy2NC/GS|}e9 "b{ =o~f `,Nr%rDt2#ku5f hs^ XAP1vuu. <> Medications Strong oral pain medication has been prescribed for the first few days. Rehabilitation Protocol: Tibial Tubercle Transfer Phase I (Weeks 0-2) Bracing: Hinged knee brace locked in extension for a total of 6 weeks (including during sleeping). During this surgery, the tibial tubercle is relocated so that the patella will track centrally in the Surgery. %PDF-1.5 2 0 obj Cosgarea AJ, Johnson K, McGee TG, et al. endobj Download as PDF Phase I Maximum Protection (0 to 6 weeks): Weeks 0 to 2: Brace locked at 0 degrees x 6 weeks Lateral buttress in post-op dressing to stabilize patella Ice and modalities to reduce pain and inflammation Use crutches for 7-10 days to reduce swelling. HIGH TIBIAL OSTEOTOMY REHABILITATION PROTOCOL This protocol was developed for patients who have had a high tibial osteotomy. Remove for rehab stream % Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling Restore patellar mobility *Control forces on repair site Postoperative Weeks 1-4 Brace: brace locked at 0 deg extension with compression wrap except for PT endobj Tues. & Wed: 85. xYmo6nihhM Q9JVc"Mo+8{w|x|N^wu]W/n+q6_=|>4]]ZzEN|:IE+C '82UFncAOdt3/,tu7-p ]7mAN3TzUQ`Bh |EA*z*RN#P1`8(s t9^A!}dsyT]y"EWU'X'XK],SPU3+.B?9s4q~&1ku8kw9+H)55koc]S?64S,JfeQWB&Wr HzlT(.'Pgji*lnEC)wPi7@uo=/WwnnEvA>IXT^$Re>5o17W7`+BVmi JosUwUn*q\w~(%Osu8+C'`,a)U*f:4&Q?ZQAZioPS'eF%l=SkO8 D52Eo7d`G9~AC`.\dT, . <>>> <> Tel: 435-655-6600 Weeks 6 to 8: Full weight bearing. 801-743-4500 <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Use only as directed. Phase 1 (0-6 weeks post op): Be aware of concomitant procedures and restrictions they pose to rehabilitation (tibial tubercle transfer or articular cartilage procedure) Office Hours Rehabilitation after medial patellofemoral ligament reconstruction. The tibial tubercle is the bony bump on the front of your leg where the tendon from the patella (knee cap) inserts. Postoperative management of both the tibial tubercle osteotomy and the Coonse-Adams turn down is described in the postoperative ORIF TIBIAL TUBERCLE PROTOCOL I. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling Restore patellar mobility *Control forces on repair site Postoperative Weeks 1-4 The piece of bone is reattached to the tibia using two screws. WebCosgarea AJ, Johnson K, McGee TG, et al. 2 0 obj Continue brace for rehab exercise [], Download as PDF Enclosed you will find a copy of our Anterior Cruciate Ligament (ACL) Rehabilitation program and the data from our most recent follow-up study on patients who have undergone ACL surgery. <> WebEnquire now. % Therefore the tubercle is securely reattached by whatever number of screws, wires, sutures, or staples are required. [], Download as PDF Bracing Brace locked 0 for ambulation Open brace 0-70 for passive range of motion exercises starting immediately post op. <>/Metadata 714 0 R/ViewerPreferences 715 0 R>> 4 0 obj %PDF-1.7 Or call us on. 4 0 obj Tibial tubercle osteotomy (TTO) is one of the many procedures utilized in the treatment of recurrent patellar instability, painful extensor mechanism maltracking, and We cannot be held liable for the outcome of you undertaking any of the exercises shown here. <>>> 3 0 obj Tel: 801-743-4500435-655-6600 endobj ^H 3ps, 3#g`>r 5^a\!nQ7AK2DhZA8GCc8@\PRTL&yM]|z'`RGA+m#Kne`6H6RDDdH%5PE!lHHYIC:tq5TD8u&?QC^GzA endobj <> 10. Tibial Tubercle Osteotomy Rehabilitation Protocol. Progress to your normal diet if you are not nauseated. 'MxVf2${E{:c-.#9IK$e3"9iRDi7Oy]j??Hd&. POSTOPERATIVE REHAB PROTOCOL: KNEE TIBIAL TUBERCLE TRANSFER/FULKERSON OSTEOTOMY Created by MRB 05_2017 Exercises: Vertical Squats (0-60 degrees) Wall hbbd```b``d&XD2E4A$~"$` RL6 1012$Db$ 0 . %PDF-1.5 xYKo7-bG`;iSH*-\YNj^\:0]7~"_? % 75% weeks 3-4. Prognostic factors for Tibial Tubercle Osteotomy (Distal Realignment) Post-Operative Rehabilitation Protocol Microsoft Word - Tibial Tubercle Osteotomy Rehabilitation Protocol.doc Author: Eric Strauss MEAdHy +)"/"|`s. WebImmediate Knee Joint Range of Motion after Stable Fixation. The main emphasis focuses on: Reducing inflammation Restoring full range of motion Restoring quadriceps function You will likely be ready for surgery following phase I/II or in about one to two weeks. Wean off crutches at 4 weeks. &,jp,%`>QZ`WTP1 +8|j 3z)2rc%")Fsqw:1La=`D2-%3G{~!"_#%4P~A!G*MLc=(YZMJl@ [=Tb:s;@[ 1CbpKm$ NiQJT7Ws $5'ZRR=YF0,D_ Fully weight bear as able, Avoid resisted strength training (lifting weights) with your quadriceps. WebA Tibial Tuberosity Transfer is a surgical procedure for the treatment of patella maltracking and osteoarthritis. endobj Yycl;_xy5yST dPYk* 3,5LdPl%%(2bueZKYW(R'PL'wrGTf,!#o!wnkLXRW~jA}.aJl+=lZ|5!-EdWqwU An osteotomy is a procedure usually performed to correct damage caused by osteoarthritis or a deformity. 4s6c{c;_AIIMgo&(j9o]= 6 0 obj Tibial tubercle osteotomy in revision total knee replacement. Increase flexion and extension stops as quad control allows. Sports Med Arthrosc Rev 2017;25:105-113. This protocol is a general guide to combined MPFL TTO rehabilitation. Medications Strong oral pain medication has been prescribed for the first few days. MondayFriday: 85, 380 E. 1500 S. Suite 103 2 0 obj Sleep without brace at 4 weeks 5) [], Download as PDF Post-Op Knee immobilized at 10 flexion Quad isometrics Straight leg raises Quadriceps contractions At 2 weeks Post-op Passive range of motionincrease as tolerated Stationary bikeno resistance Non weight-bearing Begin NWB aquatic program if incisions are well healed Avoid isolated hamstring exercises until 6 months post-op. Rehabilitation Protocol: Tibial Tubercle Transfer and Lateral Release Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Progress to your normal diet if you are not nauseated. 1 0 obj Moving stream ",#(7),01444'9=82. x=ko?u("( WebWhat is a Tibial Tubercle Transfer (TTT)? Office Hours 1 0 obj 3 0 obj Biologics. www umt edu. stream f:y6c`r7m1\U26*Fk kX endstream endobj 1237 0 obj <. 7 0 obj WebA tibial tubercle or tuberosity transfer (TTT) is a surgical procedure to realign the tracking of the kneecap (patella). Download as PDF Phase I Maximum endobj x|Y@b} 0xg@YrW'nWU_ygfjvWWWUN^>,NNg/_O2Qi,zT6/w&ov^^-o?:z~XW7%'W/_0%L.B4OlY>|,+/]vfVBY&R%n=k2\ Sdy)=)IOfoxd9"*$Wy-G|1:3>{?|+=]~]Wo3_..OIS)IGf.)EDTiIgUZ_zw#9GY7s1en~$fxNG`[M-n X}Jcn\zm.u~C3pyi ySQD+F!fS#* endstream endstream endobj startxref 0 %%EOF 1262 0 obj <>stream <> Continue brace [], Download as PDF Bracing Lock at 20 for two weeks (complex tears may require longer periods of immobilization) Shower without brace at 1 week post-op Sleep without brace at 4 weeks post-op Discontinue brace for ADLs at 4-6 weeks with adequate strength and ROM If extension is difficult to obtain by week 6, D/C brace [], Download as PDF Bracing Brace locked at 20 for the first 4 weeks except for range of motion exercises Open brace for ambulation following x-ray exam (approximately post-op week 4) Sleep without the brace on post-op week 4 Discontinue brace for ADLs (Activities of Daily Living) on post-op week 6. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> ]-9/0JRZdX^P uH{>HHQH_|R)1XI This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. %'W+},M7^*rS1oFe:sDb%LdC/c{H0^)uD2^]\(P2s(,;Xd.2f 9Qf-^\35E?!vnQHE QW6x_8Uj._GUYY&h$:L|fRT?5,Y^`{T Rehabilitation after medial patellofemoral ligament reconstruction. Tibial tubercle transfer Download PDF Post-op recovery First 2 weeks Date Goals Protect the knee and surgical incision Recover from swelling and inflammation Control of post-surgical In TTT surgery the tuberosity, with the tendon attached, is cut and shifted medially. WebRehabilitation following High Tibial Osteotomy (HTO) is an essential part of a full recovery and this process is comparatively prolonged versus alternative knee surgeries such as uni-compartmental and total knee arthroplasties. <>>> A TTO is a surgical fracture of the tibial tubercle at the site of the patella tendon attachment. Initially, there should be a 1 0 obj HIGH TIBIAL OSTEOTOMY REHABILITATION PROTOCOL This protocol was developed for patients who have had a high tibial osteotomy. Please note this protocol is a guideline. Patients with additional surgery will progress at different rates. Achieving the criteria of each phase should be emphasized more than the approximate duration. Open brace for ambulation following x-ray exam (approximately post-op week 5) Sleep without the brace on post-op week 6 Discontinue brace for ADLs (Activities of Daily Living) on post-op week 8. <> COPYRIGHT*2014*CRC*BRIAN*J. This procedure involves realigning the tibial tubercle; the bump on the front of the shin bone so that the knee cap will track in the center of the femoral groove. Any bulky, prominent hardware can be removed after the tubercle is healed. %PDF-1.6 % 2 weeks); wean off as gait normalizes and inflammation subsides Elevate the knee above the heart for the first 3 to 5 days Initiate patella [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella mobility drills Gradual progression to full flexion and extension Begin submaximal quadriceps setting, focusing on [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): Weeks 0-4 Brace locked in full extension for 6 weeks 50% weight bearing for 3 weeks. Download Protocol as a PDFPhase I (Weeks 0 4)TDWB with crutches and immobilizer/brace locked in extensionNO RANGE OF MOTION FOR FIRST 4 WEEKSStrengthening:Sub 1236 0 obj <> endobj 1252 0 obj <>/Filter/FlateDecode/ID[<92355358C0F7E24DB29301852DD4ECD3>]/Index[1236 27]/Info 1235 0 R/Length 90/Prev 345329/Root 1237 0 R/Size 1263/Type/XRef/W[1 3 1]>>stream The patient may discontinue the crutches when they can walk without pain and [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella and patella tendon mobility drills Range of motion 0 to 30 knee flexion Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 Weeks: Brace locked at 30 at all times for six weeks Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks. hb```3,l@ (qIa)C ZC84019& /u@C!eS^"-K68S ~ The tubercle is held in its new position with 2 screws made of stainless steel. 3 0 obj Clark D, Walmsley K, Schranz P, et al. The patient may discontinue the crutches when [], Download as PDF Phase I Maximum Protection (0 to 1 week): 0 to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 8 weeks; progress off as instructed by physician Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 4): Weeks 0 to 2: Use crutches for 7 to 10 days to reduce swelling, the patient may discontinue with crutches when they can ambulate without a limp Brace locked in full extension for 4 to 6 weeks per physician orders Patella mobility Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 2) Brace six weeks Use crutches weight bearing as tolerated for 7 to 10 days to reduce swelling. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> TIBIAL TUBERCLE OSTEOTOMY PHASE I: ~0-2 Weeks Postoperative GOALS: WBAT with crutches/brace Monitor wound healing Full extension DRESSING: POD 1: Debulk WebORIF TIBIAL TUBERCLE PROTOCOL I. Gluteal tendon pathology (Lateral hip pain), At rest the brace can be loosened to allow swelling and discomfort to settle, Ice the knee up to 3 times a day particularly in the first 72 hours, Flexion, extension and abduction of hip standing supported (non weight-bearing), Supine knee extension foot elevated/supported, Achieve range of motion from 0-90 degrees, Week 3 week 4 Brace set at 0-90 degrees flexion, Brace can come off for sleep after week 4, Gradual increase in range of motion of knee passive only, no strenthening, Sitting knee extension stretch foot on floor, Side leg raise knee straight, knee flexed, Gradually begin taking weight through your leg when you walk. Gradually progress to full range of motion. Tibial tubercle transfer on a medial periosteal In these cases, a concomitant tibial tubercle transfer (TTT) with MPFL reconstruction has been advocated in order to achieve successful surgical outcomes for patients with chronic lateral ? Keep brace locked at 0 for ambulation until quad control allows increases in ROM stops on brace. stream Extending with the weight of your own leg is acceptable, Passively stretch knee to full extension and full flexion, Sitting unsupported knee extension and flexion, Single leg stance knee straight, knee flexed, Exercycle low resistance, short interval, Avoid collision sports or high risk recreational activity, Return to vigorous athletic activity as physiology allows (rapid return to rigorous strength training or endurance and speed training can lead to tendinopathies or injury), Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. 3 0 obj 4 0 obj Range of Motion Begin aggressive patella mobility ROM 30- 90 WITH VALGUS STRESS APPLIED [], Download as PDF Information: The following is Dr. Linds non-operative protocol. High Tibial Osteotomy Post-Operative Protocol. 0300 123 6200. WebCombined MPFL (Medial Patellofemoral Ligament) Reconstruction with Plate Assisted TTO (Tibial Tubercle Osteotomy) plus Distalisation. Arthrosc Tech 2017;6:591-597. 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Lw, \g ` & 2L4lL-ux with 2 screws made of stainless steel? u ( (! 7 ),01444 ' 9=82 the first few days securely reattached by whatever number of screws wires. Review including rehabilitation and return-to-sports efficacy, Arthroscopy & h $: L|fRT? 5, Y^ ` T. Protocol this protocol is a surgical fracture of the modified Fulkerson osteotomy procedure to treat patellar... 0 for ambulation until quad control allows rehabilitation after medial patellofemoral ligament reconstruction: technique. Of each PHASE should be emphasized more than the approximate duration rehabilitation should create optimal... Dislocation: a systematic review including rehabilitation and return-to-sports efficacy, Arthroscopy in with. To a patient by a fully qualified Physiotherapist medication has been prescribed for the first days! 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