Early physiotherapy is directed at patella mobility in addition to static quadriceps and hamstring work maintaining muscle bulk. The most important part of the initial rehabilitation is to maintain patella mobility in the medial/lateral plane as well as the superior/inferior plane. Once the wound has settled then mobilisation of the patella tendon should also start in order to avoid any tethering and over scarring.
Range of movement exercises aim to achieve a comfortable 90 degrees bend and full straightening (extension) of the knee by 2 weeks and nearly full flexion by 6 weeks.
At 4 weeks when full weight bearing is allowed then proprioception and strength work using bicycle and rowing machines can commence.
Further rehabilitation: Initially closed chain exercises are used, protecting the patello-femoral joint. Function gradually increases, tailored to each patient, with the expectation of fast walking by 2 months building up to running and sporting activities at 4 – 6 months post surgery.