Early rapid rehabilitation may yield positive outcomes for patellar realignment surgery
Key takeaways:
- Early rehabilitation improved short-term outcomes vs. conservative rehabilitation after patellar realignment surgery.
- Early rehabilitation improved function and range of motion up to 2 years postoperatively.
Compared with conservative rehabilitation, an early rapid rehabilitation protocol may yield improved functional scores and an earlier return to daily activities after patellar realignment surgery, according to published results.
Jiayao Zhang, MD, an orthopedic surgeon at West China Hospital and Sichuan University in Chengdu, China, and colleagues randomly assigned 50 patients with recurrent patellar dislocations who underwent tibial tubercle osteotomy and medial patellofemoral ligament reconstruction to receive either early rapid rehabilitation (n = 25) or conventional rehabilitation (n = 25) between January 2018 and February 2019.
According to the study, patients who received early rapid rehabilitation made faster progressions in weight-bearing and range of motion (ROM) training. Compared with conservative rehabilitation, early rapid rehabilitation was associated with increased Tegner scores at 6 weeks and 3 months, increased Lysholm scores at 3 months and 6 months and increased IKDC scores at 6 weeks, 3 months and 1 year.
At 2 years, 23 patients in the early rapid rehabilitation cohort and 24 patients in the conventional rehabilitation cohort were available for follow-up. Zhang and colleagues found early rapid rehabilitation was associated with better ROM and decreased complications at 2 years compared with conservative rehabilitation. However, they noted no differences between the cohorts in terms of functional scores at 2 years.
Zhang and colleagues also noted early rapid rehabilitation was associated with decreased rates of patella baja at 2 years compared with conservative rehabilitation (0% vs. 17%, respectively).
“Early rapid rehabilitation is not only safe and effective but also potentially superior to conservative rehabilitation, especially in terms of early postoperative improvements in functional scores, prevention of complications and restoration of knee joint ROM,” Zhang and colleagues wrote in the study.
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