REHABILITATION OF A PATIENT FOLLOWING MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION: A CASE REPORT
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Background and Purpose: Patellar instability resulting from patellar dislocation or subluxation is a common knee problem that often requires surgical intervention. Reconstruction of the medial patellofemoral ligament (MPFL), is a surgical approach increasing in popularity. However, there are few clinical guidelines available for the rehabilitation of an individual following this operation. The primary objective of the case report is to provide guidance of the clinical management of this patient population while highlighting the need for areas of future research. Case Description: Following an MPFL reconstruction, the patient presented to physical therapy with pain, decreased knee range of motion, reduced lower extremity strength, gait abnormalities with restricted weight-bearing status, balance deficits, and abnormal posture impacting his ability to independently perform functional activities. Procedural interventions aimed at ameliorating these functional limitations included manual therapy, therapeutic exercise, neuromuscular re-education, gait training, therapeutic activity, and modalities. Outcomes: The patient responded appropriately to all interventions and made expected progress based on the assigned post-operative protocol and when compared to the literature. The patient demonstrated recovery of full range of motion, desired improvements in strength, resolution of muscular inhibition through neuromuscular re-education techniques, restoration of proper gait biomechanics, increase in stability, reduction of postural abnormalities, and an overall improvement in functional independence. Discussion: This case report provides a thorough approach for the clinical management of the rehabilitation of a patient following MPFL reconstruction. It also highlights the necessity for further research in areas of outcome assessments, implementation of advanced technology, and optimal intervention use.