The tibial tubercle is usually moved medially and anteriorly to improve the ‘Q’ angle and patella tracking. The strength of fixation of the transferred tibial tubercle will shape the surgeon’s decision on whether or not a splint is required post operatively.
Elevation of the limb
Isometric quadriceps - V.M.O. especially
Muscle pump exercises
P.W.B. (in cricket splint as necessary)
Gentle R.O.M. exercises
Progress to include:
Gradually increase range of movement but do not force.
Remain P.W.B. if not in a splint.
May be able to FWB if in a cricket splint.
(Some protection required – crutches or splint - to prevent giving way or sudden strong quadriceps contraction).
Progress to F.W.B. and abandon splint
Begin graduated quadriceps strengthening
CKC activity and proprioceptive training
Stretching all muscle groups
Full range hamstring contractions
Improved timing of VMO