Year: 2023
Type: dissertation
Study design: Case Report
Abstract: Background: The patellar tendon is a rare location for an extensor mechanism disruption, especially among individuals without predisposing risk factors. Rehabilitation after surgical repair of patellar tendon rupture in a child presents unique challenges not yet documented in current literature. The purpose of this case report is to highlight clinical decision-making associated with physical therapy treatment of a young child after surgical repair of an isolated traumatic patellar tendon rupture. Case Description: The patient was a healthy, 7-year-old female without predisposing comorbidities who sustained a traumatic mid-substance tear of the patellar tendon after a fall from a height. She underwent a subsequent unilateral knee arthroscopy and end-to-end patellar tendon repair. Upon her initial physical therapy visit 6 weeks after surgery, she demonstrated unilateral knee pain, limited knee range of motion, quadriceps atrophy, significant gait deviations, and considerable kinesiophobia. Intervention: Early physical therapy interventions highlighted in this report aimed to increase passive knee range of motion, normalize independent gait and stair negotiation, and minimize kinesiophobia. Middle rehabilitation interventions hinged on gait pattern refinement, active and passive knee range of motion gains, unilateral quadriceps strengthening, and balance refinement. Late phase interventions included agility and plyometric drills to prepare the patient for a return to sport activities. Outcome Measures: After ten weeks of outpatient physical therapy participation, this patient improved her quadriceps strength and symmetry, achieved nearly symmetrical passive knee range of motion, demonstrated independent gait and stair negotiation without observable deviations, and reported full confidence to return to soccer. Discussion: This case provides an example of interventions utilized during rehabilitation of a traumatic patellar tendon disruption. It also addresses unique biological and psychological considerations pertaining to orthopedic rehabilitation of a child. Future research is warranted to address the efficacy of post-operative patellar tendon repair protocols in a pediatric population.
Author: Douglas, Katherine
Institution: University of Iowa
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223597083