This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a Tibial Plateau ORIF (Open Reduction Internal Fixation) procedure.
The document is divided into six phases, each with specific:
- **Goals:** Objectives for each phase, such as reducing swelling and edema, minimizing pain, restoring range of motion, improving gait mechanics, and increasing strength and proprioception.
- **Restrictions:** Guidelines for weight-bearing (flat foot touch down, progressing to full weight-bearing), brace usage (T-Scope), and range of motion limitations.
- **Therapeutic Exercises:** Prescribed activities focusing on range of motion (PROM, AROM, AAROM), edema control, pain management, strengthening (quadriceps, hip, gluteal), closed-chain exercises, balance exercises, progressive resistance exercises, aquatic therapy, and eventually jogging and functional progressions.
- **Criteria for Progression:** Benchmarks for moving to the next phase, including achieving range of motion goals, strength levels, and absence of pain or instability.
- **Criteria for Discharge:** Surgeon clearance, specific hamstring and quadriceps strength indices compared to the contralateral limb, Y-Balance anterior reach measurement, and absence of pain or instability.
The phases progress from initial post-operative care with touch-down weight-bearing and a T-Scope brace to full return to activity and sports, with increasing exercise intensity and functional demands. The protocol also includes criteria for progression and discharge, such as strength indices and a Y-Balance test.
