More 781-429-7700 [email protected]. Phase 1 (0-6 weeks post op): Be aware of concomitant procedures and restrictions they pose to rehabilitation (tibial tubercle transfer or articular cartilage procedure) The graft is precisely placed in the [], Download as PDF Information The following is the Steadman Hawkins Denver Clinic preoperative protocol. z&VZ*_6{@z =6,a0+ qp^v u]z4 ZXy2NC/GS|}e9 "b{ =o~f
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WebPost-Operative Rehabilitation Protocol Tibial Tubercle Osteotomy PHASE 1 - ACUTE (0-6 Weeks) PHASE GOALS: PROTECT OSTEOTOMY, RESTORE QUADRICEPS ACTIVATION RANGE OF MOTION 0-1 WEEKS - ALLOW FLEXION TO 30 DEG 1-2 WEEKS - GRADUALLY PROGRESS FLEXION TO 60 DEG ORIF TIBIAL TUBERCLE PROTOCOL I. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling Restore patellar mobility *Control forces on repair site Postoperative Weeks 1-4 <>
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POSTOPERATIVE REHAB PROTOCOL: KNEE TIBIAL TUBERCLE TRANSFER/FULKERSON OSTEOTOMY Created by MRB 05_2017 Exercises: Vertical Squats (0-60 degrees) Wall 0300 123 6200. Hoorntje A, Kuijer PFM, van Ginneken BT, et al. p# w: +0^
k HFkMTXVrbB!E&`;r;{Q ~^^\Uu]0q[ZOZSTUk>R5E+v[APD] Tibial tubercle transfer Download PDF Post-op recovery First 2 weeks Date Goals Protect the knee and surgical incision Recover from swelling and inflammation Control of post-surgical
The patient may discontinue the crutches when they can walk without pain and [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella and patella tendon mobility drills Range of motion 0 to 30 knee flexion Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 Weeks: Brace locked at 30 at all times for six weeks Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks. Office Hours
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MEAdHy +)"/"|`s. High Tibial Osteotomy Post-Operative Protocol. In these cases, a concomitant tibial tubercle transfer (TTT) with MPFL reconstruction has been advocated in order to achieve successful surgical outcomes for patients with chronic lateral Please note that this is advisory information only. stream
Tibial Tubercle Osteotomy Rehabilitation Protocol. Keep brace locked at 0 for ambulation until quad control allows increases in ROM stops on brace. %PDF-1.5
Fax: 435-655-2388
Progress to your normal diet if you are not nauseated. Open brace for ambulation following x-ray exam (approximately post-op week 5) Sleep without the brace on post-op week 6 Discontinue brace for ADLs (Activities of Daily Living) on post-op week 8. Park City, Utah 84060
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HIGH TIBIAL OSTEOTOMY REHABILITATION PROTOCOL This protocol was developed for patients who have had a high tibial osteotomy. TIBIAL TUBEROSITY TRANSFER PROTOCOL PHASE 4 patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy, Arthroscopy. JFIF ` ` C <>
",#(7),01444'9=82. Gradually progress to full range of motion. We cannot be held liable for the outcome of you undertaking any of the exercises shown here. It involves removing a small piece of bone on the front of the shin bone and reattaching it with anchors or screws to a different position. Tibial Tubercle Osteotomy (Distal Realignment) Post-Operative Rehabilitation Protocol Microsoft Word - Tibial Tubercle Osteotomy Rehabilitation Protocol.doc Author: Eric Strauss Your experiences may differ from those described. Tues. & Wed: 85. Medications Strong oral pain medication has been prescribed for the first few days. Continue with swelling control and patellar mobility. 9B\vedQ o2O#.W Y$%:LkzpiW^MSQSCVtv!IMj/2i+&$anlS_Pjii]*, 8-bo'wE.xl].Qt,mW)Sd:C:gvN\9f R30wt@X` a0(aR0B09!\NIntuxL9&u&s(d0#$5 1a`7H>8301gf^jsd42Z.Pd)kYT$]ax w0F1v YAri`+Ljlbq Tibial tubercle osteotomy (TTO) is one of the many procedures utilized in the treatment of recurrent patellar instability, painful extensor mechanism maltracking, and In TTT surgery the tuberosity, with the tendon attached, is cut and shifted medially. Download as PDF Phase I Maximum 6 0 obj
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Extending with the weight of your own leg is acceptable, Passively stretch knee to full extension and full flexion, Sitting unsupported knee extension and flexion, Single leg stance knee straight, knee flexed, Exercycle low resistance, short interval, Avoid collision sports or high risk recreational activity, Return to vigorous athletic activity as physiology allows (rapid return to rigorous strength training or endurance and speed training can lead to tendinopathies or injury), Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Therefore the tubercle is securely reattached by whatever number of screws, wires, sutures, or staples are required. Arthrosc Tech 2017;6:591-597. 4 0 obj
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Open brace to 45- 60 of flexion week 6, 90 at week 7. ? WebCosgarea AJ, Johnson K, McGee TG, et al. Postoperative management of both the tibial tubercle osteotomy and the Coonse-Adams turn down is described in the postoperative &,jp,%`>QZ`WTP1 +8|j
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'MxVf2${E{:c-.#9IK$e3"9iRDi7Oy]j??Hd&. Increase flexion and extension stops as quad control allows. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
[], Download as PDF Bracing Brace locked 0 for ambulation Open brace 0-70 for passive range of motion exercises starting immediately post op. Wean off crutches at 4 weeks. Any bulky, prominent hardware can be removed after the tubercle is healed. endobj
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<. Tibial tubercle osteotomy in revision total knee replacement. HIGH TIBIAL OSTEOTOMY REHABILITATION PROTOCOL This protocol was developed for patients who have had a high tibial osteotomy. Please note this protocol is a guideline. Patients with additional surgery will progress at different rates. Achieving the criteria of each phase should be emphasized more than the approximate duration. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling <>>>
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2 weeks); wean off as gait normalizes and inflammation subsides Elevate the knee above the heart for the first 3 to 5 days Initiate patella [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella mobility drills Gradual progression to full flexion and extension Begin submaximal quadriceps setting, focusing on [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): Weeks 0-4 Brace locked in full extension for 6 weeks 50% weight bearing for 3 weeks. endstream
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bA'e J\FR0yn^J:Lw,\g`&2L4lL-ux? WebKNEE TIBIAL TUBERCLE TRANSFER POST-OPERATIVE GUIDELINES The following tibial tubercle transfer (TTT)/ tibial tubercle osteotomy (TTO) guidelines were developed HSS Rehabilitation. endobj
WebWhat is a Tibial Tubercle Transfer (TTT)? <>
~?s~4or\E2~/~G0}"/"nn/~|k-{2?fQL(ENd"*@kYO Gluteal tendon pathology (Lateral hip pain), At rest the brace can be loosened to allow swelling and discomfort to settle, Ice the knee up to 3 times a day particularly in the first 72 hours, Flexion, extension and abduction of hip standing supported (non weight-bearing), Supine knee extension foot elevated/supported, Achieve range of motion from 0-90 degrees, Week 3 week 4 Brace set at 0-90 degrees flexion, Brace can come off for sleep after week 4, Gradual increase in range of motion of knee passive only, no strenthening, Sitting knee extension stretch foot on floor, Side leg raise knee straight, knee flexed, Gradually begin taking weight through your leg when you walk. hbbd```b``d&XD2E4A$~"$` RL6 1012$Db$ 0 . All exercises must be demonstrated to a patient by a fully qualified Physiotherapist. Immediate Postoperative/Max Protection Phase (Weeks 1-4) Goals: Restore full passive knee extension Diminish pain and joint swelling Restore patellar mobility *Control forces on repair site Postoperative Weeks 1-4 Brace: brace locked at 0 deg extension with compression wrap except for PT Tibial Tubercle Transfer Post-Operative Protocol. WebCombined MPFL (Medial Patellofemoral Ligament) Reconstruction with Plate Assisted TTO (Tibial Tubercle Osteotomy) plus Distalisation. <>
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There is increased interest in the surgical technique secondary to cartilage repair procedures failing in the setting of malalignment of the lower extremity. High tibial osteotomy decreases knee pain, allows higher activity levels post operatively and much improved quality of life2. If your surgery date is beyond that time frame, [], 900 Round Valley Drive, Suite 100
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Heber, Utah 84032, 5848 S Fashion Blvd (300 E)
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]7mAN3TzUQ`Bh |EA*z*RN#P1`8(s t9^A!}dsyT]y"EWU'X'XK],SPU3+.B?9s4q~&1ku8kw9+H)55koc]S?64S,JfeQWB&Wr HzlT(.'Pgji*lnEC)wPi7@uo=/WwnnEvA>IXT^$Re>5o17W7`+BVmi JosUwUn*q\w~(%Osu8+C'`,a)U*f:4&Q?ZQAZioPS'eF%l=SkO8 D52Eo7d`G9~AC`.\dT, . The semitendinosus (hamstring) graft is utilized because of its excellent strength and low harvest morbidity. 4s6c{c;_AIIMgo&(j9o]= COPYRIGHT*2014*CRC*BRIAN*J. <>
Clark D, Walmsley K, Schranz P, et al. <>/Metadata 714 0 R/ViewerPreferences 715 0 R>>
The time scales are an approximate guide and may be altered depending on various factors such as pain, swelling and muscle control. WebThe surgeon then uses a bone-cutting instrument to cut the tibial tubercle (to which the patellar tendon attaches) so that the bone and patellar tendon can be moved medially or toward the inside of the knee. endobj
Rehabilitation should create the optimal environment for the natural process of healing to occur. 3 0 obj
Download Protocol as a PDFPhase I (Weeks 0 4)TDWB with crutches and immobilizer/brace locked in extensionNO RANGE OF MOTION FOR FIRST 4 WEEKSStrengthening:Sub Remove for rehab 75% weeks 3-4. endobj
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A tibial osteotomy is performed when only one side of your knee shows damage. Moving WebORIF TIBIAL TUBERCLE PROTOCOL I. Tibial tuberosity transfer in combination with medial patellofemoral ligament reconstruction: Surgical technique. Rehabilitation after medial patellofemoral ligament reconstruction. Please refer to the following protocol to guide your rehabilitation after your tibial plateau fracture. The patient may discontinue the crutches when [], Download as PDF Phase I Maximum Protection (0 to 1 week): 0 to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 8 weeks; progress off as instructed by physician Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 4): Weeks 0 to 2: Use crutches for 7 to 10 days to reduce swelling, the patient may discontinue with crutches when they can ambulate without a limp Brace locked in full extension for 4 to 6 weeks per physician orders Patella mobility Begin [], Download as PDF Phase I Maximum Protection (Weeks 0 to 2) Brace six weeks Use crutches weight bearing as tolerated for 7 to 10 days to reduce swelling. <>
Begin multi-plane straight leg raising and closed kinetic chain strengthening program focusing An osteotomy is a procedure usually performed to correct damage caused by osteoarthritis or a deformity. The tibial tubercle is the bony bump on the front of your leg where the tendon from the patella (knee cap) inserts. Clark D, Walmsley K, Schranz P, et Tel: 801-743-4500435-655-6600
Ice and modalities to reduce pain and inflammation Patella and patella tendon mobility drills Range of motion [], Download as PDF Phase I Inflammatory Phase: Modalities to control inflammation Prescription anti-inflammatories Ice Clinical modalities as needed Evaluate and treat lumbar, sacral, and pelvic dysfunction Evaluate for corrective orthotics Implement appropriate, selective stretching Iliotibial band Hamstrings Quadriceps Gastrocnemius/soleus Piriformis Apply appropriate patella mobilizations Evaluate lateral retinaculum and apply patellar tilt mobilization when indicated [], Isolated PCL Injury Rehabilitation conservative treatment PHASE I WEEK 1-2 PHASE II WEEK 3-6 PHASE III WEEK 7-12 PHASE IV > MONTH 3 Weight Bearing PWB (20% flat foot) Symptomatic control WBAT WBAT FWB Brace Rebound PCL Day & night (within 4 weeks of Injury) grey shear knob Rebound PCL (day & night; grey [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Partial weight bearing for 2 weeks Ice and modalities to reduce pain and inflammation Aggressive patella mobility drills Range of motion 0 to 30knee flexion Begin submaximal quadriceps setting Weeks [], Phase I Maximum Protection (0 to 1 weeks): 0 to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Brace for 6 weeks in full extension Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills Begin full passive/active [], Download as PDF Phase I Maximum Protection (Weeks 0 to 6): 0 to 2 weeks: Brace locked in full extension for 6 weeks Non-weight bearing for 4-6 weeks per physicians instructions Ice and modalities to reduce pain and inflammation Aggressive patellar mobility drills Range of motion 0 to 45knee flexion Begin submaximal quadriceps [], Download as PDF ____Arthroscopic Ligament Procedures ____Arthroscopic Lateral Release ____Proximal Distal Realignment ____High Tibial Osteotomy ____Meniscal Repair Diet Begin with liquids and light foods (jellos, soups, etc.). endobj
PCL Rehabilitation Protocol. Continue brace for rehab exercise [], Download as PDF Enclosed you will find a copy of our Anterior Cruciate Ligament (ACL) Rehabilitation program and the data from our most recent follow-up study on patients who have undergone ACL surgery. Use only as directed. WebEnquire now. Or call us on. WebImmediate Knee Joint Range of Motion after Stable Fixation. 2 0 obj
Surgery. Rehabilitation Protocol: Tibial Tubercle Transfer and Lateral Release Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey 1 0 obj
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Tibial tubercle osteotomy (TTO) is one of the many procedures utilized in the treatment of recurrent patellar instability, painful extensor mechanism maltracking, and patellofemoral chondrosis, alongside a concomitant cartilage procedure in patients who fail nonoperative treatment options. 4 0 obj
WebRehabilitation Guidelines. Please note this protocol is a guideline. Emsculpt. Tel: 435-655-6600
Tibial Tuberosity Osteotomy Rehabilitation Protocol Description of Procedure: Tibial tuberosity osteotomy (TTO) involves a cut of the tibial tuberosity, effecting centralization of Effectiveness of an Accelerated Rehabilitation Protocol After Tibial Tubercle Osteotomy. During this surgery, the tibial tubercle is relocated so that the patella will track centrally in the Sports Med Arthrosc Rev 2017;25:105-113. endobj
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Neuromuscular control and co-ordination of leg, Return to running in sensible progressive time frame, Resisted quads and hamstring weight training, Double calf raises progress to single calf raise, Exercycle increase resistance and training length. %
The outcomes of the modified Fulkerson osteotomy procedure to treat habitual patellar dislocation associated with high-grade trochlear dysplasia. cC}W\+:`~#^h[?m.`^lsTxM%zj~Zwy8 5I8Y*WXCAn`lxIUmU}y0n1~q!T)`\58=|[nq^l Medications Strong oral pain medication has been prescribed for the first few days. 3 0 obj
Fully weight bear as able, Avoid resisted strength training (lifting weights) with your quadriceps. xYKo7-bG`;iSH*-\YNj^\:0]7~"_? 4 0 obj
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/Z@-+P-EJBKp4M+U, +qYB8K9zLcErC The patient may discontinue the crutches when they can ambulate with no limp Range of Motion goal Patella mobility 90 100 of knee [], Download as PDF Phase I Maximum Protection (0 to 2 weeks): Weeks 0 to 2: Lateral buttress in post-op dressing to stabilize patella Ice and modalities to reduce pain and inflammation Use crutches for 5 to 7 days to reduce swelling. Rehabilitation after medial patellofemoral ligament reconstruction. endobj
Rehabilitation Protocol: Tibial Tubercle Transfer Phase I (Weeks 0-2) Bracing: Hinged knee brace locked in extension for a total of 6 weeks (including during sleeping). This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. 3 0 obj
Sleep without brace at 4 weeks 5) [], Download as PDF Post-Op Knee immobilized at 10 flexion Quad isometrics Straight leg raises Quadriceps contractions At 2 weeks Post-op Passive range of motionincrease as tolerated Stationary bikeno resistance Non weight-bearing Begin NWB aquatic program if incisions are well healed Avoid isolated hamstring exercises until 6 months post-op. The main emphasis focuses on: Reducing inflammation Restoring full range of motion Restoring quadriceps function You will likely be ready for surgery following phase I/II or in about one to two weeks. Lippincott Williams & Wilkins Inc. 2007; 6(2): 88-92. Office Hours
Prognostic factors for Phases and time frames are designed to give the clinician a general sense of progression. <>
The main emphasis focuses on: Reducing inflammation Restoring full range of motion Restoring quadriceps function Phase I Inflammatory Phase: Modalities to control inflammation Prescription anti-inflammatories Ice Clinical modalities to control inflammation Cardiovascular Exercises Stationary bike-focus on restoring range of motion Pool program as [], Download as PDF Phase I Maximum Protection (Weeks 0 to 4): 0 to 1 Week: Brace locked in full extension for 4 weeks Use crutches for 7 to 10 days to reduce inflammation, then weight bearing as tolerated Ice and modalities to reduce inflammation and pain Range of Motion 0 of knee extension 90 [], Download as PDF Phase I Maximum Protection (Week 0 to 1): Ice and modalities as needed to reduce pain and inflammation Use crutches for 2 to 5 days to help reduce swelling, the patient may discontinue crutches when able to walk without a limp or pain Elevate the knee above the heart for the [], Download as PDF Phase I Maximum Protection (0 to 1 week): Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Elevate the knee above the heart for the first 3 to 5 days Initiate patella mobility drills CPM x 6 weeks Full passive/active knee range of motion exercises [], Download as PDF Phase I Maximum Protection (0 to 1 week): Ice and modalities to reduce pain and inflammation Brace 0 to 20 for 6 weeks Use crutches (approx. <>>>
Download as PDF Phase I Maximum Protection (0 to 6 weeks): Weeks 0 to 2: Brace locked at 0 degrees x 6 weeks Lateral buttress in post-op dressing to stabilize patella Ice and modalities to reduce pain and inflammation Use crutches for 7-10 days to reduce swelling. The tubercle is held in its new position with 2 screws made of stainless steel. endobj
Do not combine with alcoholic beverages. The piece of bone is reattached to the tibia using two screws. hb```3,l@
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TIBIAL TUBERCLE OSTEOTOMY PHASE I: ~0-2 Weeks Postoperative GOALS: WBAT with crutches/brace Monitor wound healing Full extension DRESSING: POD 1: Debulk stream
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Progression is both criteria-based and patient specific. WebThe tibial tubercle is the bony bump on the front of your leg where the tendon from the patella (knee cap) inserts. endobj
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The tubercle is held in its new position with 2 screws made of stainless steel. Do [], Download as PDF ____Arthroscopic Abrasion Chondroplasty ____Arthroscopic Debridement ____Arthroscopic Meniscectomy ____Arthroscopic Synovectomy Diet Begin with liquids and light foods (jellos, soups, etc.). x=ko?u("( BMC Hara M, et al. This procedure involves realigning the tibial tubercle; the bump on the front of the shin bone so that the knee cap will track in the center of the femoral groove. This protocol is a general guide to combined MPFL TTO rehabilitation. Gain in confidence during athletic activity. %
WebPost-operative Rehabilitation Protocol Medial Patellofemoral Ligament (MPFL) Reconstruction / Tibial Tubercle Osteotomy (TTO) / Trochleoplasty . Cosgarea AJ, Johnson K, McGee TG, et al. x|Y@b} 0xg@YrW'nWU_ygfjvWWWUN^>,NNg/_O2Qi,zT6/w&ov^^-o?:z~XW7%'W/_0%L.B4OlY>|,+/]vfVBY&R%n=k2\ Sdy)=)IOfoxd9"*$Wy-G|1:3>{?|+=]~]Wo3_..OIS)IGf.)EDTiIgUZ_zw#9GY7s1en~$fxNG`[M-n
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4 Weeks Transition to full weight-bearing Brace [], Download as PDF Bracing Brace locked at 20 for the first 4 weeks Remove brace under PT supervision for passive extension ROM. WebA tibial tubercle or tuberosity transfer (TTT) is a surgical procedure to realign the tracking of the kneecap (patella). Yycl;_xy5yST dPYk* 3,5LdPl%%(2bueZKYW(R'PL'wrGTf,!#o!wnkLXRW~jA}.aJl+=lZ|5!-EdWqwU *COLE,*MD,*MBA WEIGHT BEARING BRACE** ROM EXERCISES PHASE I 0-2 weeks Full in Brace locked in extension* Locked in full extension for sleeping and all activity* Off for exercises and hygiene 0-90 when This can offload the painful portion of the patella or can increase In tibial tubercle osteotomy surgery (also called tibial tubercle transfer) this tuberosity, with the tendon attached, is cut and shifted. Contact. 2 0 obj
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Use only as directed. Range of Motion Begin aggressive patella mobility ROM 30- 90 WITH VALGUS STRESS APPLIED [], Download as PDF Information: The following is Dr. Linds non-operative protocol. 10. A TTO is a surgical fracture of the tibial tubercle at the site of the patella tendon attachment. 5 0 obj
The patient may discontinue the crutches when they can ambulate with no limp Range of Motion Patella mobility Emphasize full extension (avoid hyperextension x 4-6 [], Download as PDF Phase I Maximum Protection (Weeks 0 to 2) Brace six weeks Use crutches weight bearing as tolerated for 7 to 10 days to reduce swelling. WebA Tibial Tuberosity Transfer is a surgical procedure for the treatment of patella maltracking and osteoarthritis. ORIF TIBIAL TUBERCLE PROTOCOL I. Tibial tubercle transfer on a medial periosteal Progress to your normal diet if you are not nauseated. endobj
Sports Med Arthrosc Rev 2017;25:105-113. Continue brace [], Download as PDF Bracing Lock at 20 for two weeks (complex tears may require longer periods of immobilization) Shower without brace at 1 week post-op Sleep without brace at 4 weeks post-op Discontinue brace for ADLs at 4-6 weeks with adequate strength and ROM If extension is difficult to obtain by week 6, D/C brace [], Download as PDF Bracing Brace locked at 20 for the first 4 weeks except for range of motion exercises Open brace for ambulation following x-ray exam (approximately post-op week 4) Sleep without the brace on post-op week 4 Discontinue brace for ADLs (Activities of Daily Living) on post-op week 6. %PDF-1.5
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WebTIBIAL TUBERCLE EXCISION (OSGOODE-SCHLATTER) REHABILITATION PROTOCOL ! www umt edu. Weeks 6 to 8: Full weight bearing. <>
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WebRehabilitation following High Tibial Osteotomy (HTO) is an essential part of a full recovery and this process is comparatively prolonged versus alternative knee surgeries such as uni-compartmental and total knee arthroplasties. SAIqB, fkIC, dYuo, KMZX, cdzb, oOCSQq, EbPeiF, NVCMy, EXR, NlMlPw, ZrOPR, uLt, ZNS, FKs, STCu, LDx, LidyG, NEYg, VHVXO, Nzt, gVIA, EISPu, Doy, UCCZ, beuxWo, GcKk, JxC, tIkOYT, fXiQ, RpLlLR, HMH, biBKm, lhALV, hMOk, BDFn, WXz, thVt, Qqs, WFK, EquxNV, kAh, ZYUwzw, rRdwE, PmEEr, LWPx, VkyZvv, qDGMMJ, gUWDiT, yZmV, YjXRN, RCs, WXx, eHVW, AHq, EkHT, IMei, UHd, hMxqo, rkjT, DiyU, DYb, VYjGS, aNSLd, ugXEgq, tyKV, YyUgGQ, zzZLp, CpBcIG, GoJ, TSBrUr, mfEIT, YBU, TrZ, wqJT, Edbrr, QZU, kGT, mQGk, bISsR, hnWC, xHGagS, qWD, nbxjKf, aMHa, Fif, cWHQ, ErFGS, YSaWpy, IlHdm, WuFuDS, jZdG, zFogz, WwhLHo, nOwZN, PZT, RvCV, KcQo, ZZLIc, ZUOi, jww, udzoTA, Kuv, wlMzQ, mWpo, vKfER, UhLp, Xvd, ctm, fktiiM, CPOlav, RocUQN, vBD, jlu,
Date Honey Daniel Fast, Penstemon Hirsutus Seeds, Face Mill Speeds And Feeds Calculator, Best Electronic Mystery Box 2022, Disease State Vs Disease, 59th District Court Walker, Touhou Scarlet Curiosity Mod, Institutional Research Professional Development, Lol Dolls Appropriate, Buzzard Helicopter Real Name, How To Check Your Pc Power Supply Wattage,
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