This document, authored by Jared T. Lee, MD, provides a rehabilitation plan for patients following a Patella Fracture ORIF (Open Reduction Internal Fixation) procedure.
The document is divided into five phases, each detailing:
- **Restrictions:** Guidelines for weight-bearing (weight-bearing as tolerated with the brace locked in extension initially), brace usage (brace locked in extension, then unlocked), range of motion limitations, and activity restrictions.
- **Therapeutic Exercises:** Prescribed activities for each phase, focusing on passive range of motion, edema control, pain management, isometric quadriceps strengthening, hamstring and hip strengthening, straight leg raises, active and active-assisted range of motion, gait training, stationary biking, double-leg strengthening, aquatic therapy, deceleration, single leg hopping, cutting, agility, and sports specific activities.
- **Goals:** Objectives for each phase, such as reducing swelling and edema, minimizing pain, restoring range of motion, protecting the surgical repair, initiating muscular activation and strengthening, progressing functional movement training, and improving proprioception.
- **Criteria for Discharge:** Specific metrics for discharge, including strength deficit (less than 10% in quadriceps and gluteals), limb similarity index (90% or greater on functional hop and Y balance tests), 45/50 on biomechanical functional assessment tests (if performed), and no pain or complaints of instability with functional progression of sports specific skills.
The phases progress from initial post-operative care with weight-bearing as tolerated in a locked brace to full return to activity and sports, with increasing exercise intensity and functional demands.