Date of Award

2007

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Peggy Mohr

Keywords

Adolescent; Patellar Dislocation -- rehabilitation; Patellar Ligament -- injuries

Abstract

Background and Purpose. The treatment of adolescents with lateral patellar instability has changed greatly in recent years. For surgical treatment of recurrent dislocation, the intervention of choice has become medial patellofemoral ligament (MPFL) repair or reconstruction. The purpose of this case study is to discuss recent trends in management of patients suffering from chronic patellar instability, and particularly to describe the post-operative management of this adolescent female who underwent medial patellofemoral ligament reconstruction.

Case Description. Having failed a trial of conservative rehabilitation, a 12-year-old female athlete with a history of recurrent patellar dislocation underwent MPFL reconstruction. Her postsurgical rehabilitation program focused on early mobilization and quadriceps activation, progressing into a closed kinetic chain and proprioception focused regimen. Electrical stimulation to the quadriceps, biofeedback, passive range of motion, friction massage to scar tissue, and patellar mobilization were also employed.

Outcome. The patient showed significant positive gains in range of motion, strength, proprioception, and function. She had no pain. She reported no feelings of patellar instability.

Discussion. Despite the ongoing presence of other biomechanical risk factors, patients who undergo MPFL reconstruction typically report good to excellent outcomes and re-dislocation is uncommon. The rehabilitation regimen outlined in this case report appears to be efficacious.

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