Date of Award

2015

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Gary Schindler

Keywords

Ligaments, Articular -- surgery; Patellar Dislocation -- rehabilitation; Physical Therapy Modalities; Case Reports

Abstract

Background and Purpose: The medial patello-femoral ligament (MPFL) is the primary soft tissue structure that withstands forces throughout range of motion (ROM) to prevent the patella from sliding over the lateral femoral condyle and dislocating from the patellar groove. Impaired stabilization and line of pull of the patella can directly affect the patella and the entire kinematic chain during movement. MPFL reconstruction has become the most popular surgical treatment to correct this anomaly when conservative strengthening and biomechanical correcting treatments have failed. This case study evaluates the effectiveness of physical therapy treatment pre-operative and postoperative MPFL reconstruction, and discusses the outcomes experienced by the patient.

Case Description: The patient was a 36 year old female who received physical therapy treatment before and after MPFL reconstruction surgery. Treatment consisted of 6 pre-op visits and 16 post-op visits, a total of 22 visits.

Interventions: Physical therapy interventions focused on increasing left knee ROM and quadriceps strength, stability, endurance; improve balance, functional mobility measured by LEFS, and functional activities of the patient.

Outcomes: Over the course of treatment, the patient's pain was abolished, lower extremity strength equaled 5/5 bilaterally, knee ROM equaled 0-135° bilaterally, functional mobility improved, and she was able to return to caring for her children and completing household tasks safely and independently.

Discussion: The patient responded well to treatment with all short term and long term goals being met. However, additional research is needed in treating post-MPFL reconstruction to distinguish the best evidence based approach for effective rehabilitation

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