Question - Patella Dislocation (when to start motion)

I am a physiotherapist seeing an acute patellar dislocation...my client was seen only by an ER doc and given no instructions for recovery....he's in a full zimmer brace (no flexion )...i am wondering when he can start to slowly bend his knee (ie. do i need to wait 3-4 weeks, or can i work within his pain)..thank-you!

Comments for
Question - Patella Dislocation (when to start motion)

Average Rating

Click here to add your own comments

Sep 09, 2008
Rating

Every physician is different
by: Bart - SII

As I am sure you are aware, every doctor is a little different in how they want to progress their patients - however, since he was seen in the ER, my guess is that there isn't a strict protocol that they would have you follow.

I am a firm believer in early pain free motion. The longer the knee remains immobile, the longer the recovery takes.

I start my patients with early motion to tolerance during the first 7-10 days after injury - I avoid flexion past 90 degress for 2-3 weeks, and then progress as tolerated from there. 7-10 days allows for the initial inflammatory stages to subside, and after 3 weeks there is a good scar matrix formed and the controlled motion will allow for collagen alignment and increased Type I deposits, strengthening the scar matrix.

Working on restoring quadriceps function is probably my number one goal early on with patellar dislocations, as once the quad fires, everything else seems to fall into place.

Bart