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Rehabilitation: Patello-femoral Joint Lesions

0-6 Weeks Rehabilitation:

• Weight bearing as tolerated
• Brace locked at 0-20 for 6/52 when mobilising (After 6/52 brace is gradually opened before discontinued)
• Range of motion (out of brace) – free flexion as tolerated aiming for full flexion by 6/52
• Stationary bike after 1-2 weeks when 1000 flexion achieved. 500 revolutions 3 times a day. No or minimal load.
• Gym ball Flex/Ext (Heel on ball)
• Circulation exercises
• Heel slides
• SLR
• Static quads, hamstring & gluteii
• Hamstring/calf stretches in long sitting
• Heel raises in standing
• Patella mobilisations (not into pain or end of range)
• Early proprioceptive exs (Single leg standing)

After 3 weeks add in following:

• Hip Flex/Ext/Abd/Add in standing knee Ext with theraband
• Progress proprioception exs (Trampette single leg stand)
• Rowing machine (No hands)

Week 6 Goals:
• Full Ext
• 120° Flex
• Minimal pain & swelling
• Good static quads control

7-12 Weeks Rehabilitation:

• Remove brace
• Progress to full ROM
• Gait re-education
• Functional closed chain 10cm step up (40º)
• Progress proprioception:-
 Trampette double leg / single leg stand
 Wobble board
• Treadmill slow walk
• ↑ Static ex bike /ordinary bike
• Knee Ext 0 – 30º in standing with resistance of theraband
3 Month Goals:
• Normal Gait
• Full AROM
• Good knee control
• No load on patellofemoral joint for 3/12
• No swelling & minimal pain

3 – 6 Months Rehabilitation:

• ↑ Functional training
• Treadmill fast walk – supervised only
• Stepper/cross trainer
• ↑ Walking distance
• Patello femoral rehabilitation
• Lateral & forward step down 10cm
• Circuit training
• Progress activity to supervised jogging
• No jogging unsupervised until 6 months

6 Month Goals:
• FROM
• No pain & no swelling
• Strength within 80-90% of contralateral extremity (quads & hams)
• Perform 10cm step down & neutral pelvis

6 Months onwards: Return to full sport phase

• Exercises as per 6/12 femoro-tibial protocol
• Progressing to sport specific training
cartilage repair

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