Patellofemoral Reconstruction

Tibial Tubercle Transfer

A patellofemoral reconstruction or re-alignment is performed to correct recurrent instability, dislocation or “giving way” of the knee.

The patella or kneecap slides up and down a shallow groove (the trochlear groove) and is kept on track by ligaments and muscles. Mal-tracking, instability or giving way occur when the ligaments and muscles are either weak, too tight, torn, stretched, etc. Sometimes the patella pops in and out of the groove during motion, which is known as subluxation.

Patients are hospitalised for one to two nights and discharged on crutches (usually required for six weeks) and braced for approx. six weeks. The wound should be kept dry for ten to fourteen days when the patient should see Dr Wood for a check up consultation. A second consultation is required at six to eight weeks with an x-ray to check tibial tubercle union.

Sedentary or office workers usually return to work two to four weeks after surgery. Labourers usually require twelve weeks off work.

Possible Complications
– Infection, deep vein thrombosis or blood clots, numbness on the skin, recurrence

Physiotherapy Schedule – guideline

0 – 6 WEEKS
Usually locked at 0°. Brace and static quadriceps rehabilitation
Short VMO retraining. Weight bearing as tolerated in brace.

6 – 8 WEEKS
Full weight bearing and static quadriceps
Work range to limit. Continue with VMO work

8 – 10 WEEKS
Active quadriceps rehabilitation and increase range of motion to 90°

10 – 12 WEEKS
Go for full range of motion and full active quadriceps

12 – 14 WEEKS
Mini trampoline, bike riding, etc.

After 14 weeks – full activities if quadriceps fully rehabilitated.