Rehabilitation After Right Tibial Plateau Fracture with ACL Tear - Orthopedics

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Rehabilitation after a right tibial plateau fracture combined with an anterior cruciate ligament (ACL) tear is a critical process that requires careful attention to detail and a structured approach. Given that you are six weeks post-surgery, it is essential to focus on regaining range of motion, strength, and functional stability in your knee. Here’s a comprehensive guide on how to approach your rehabilitation.


1. Understanding Your Condition
The tibial plateau is the upper surface of the tibia (shinbone) that forms part of the knee joint. A fracture in this area can significantly impact knee function, especially when combined with an ACL tear. The surgical intervention you underwent, which involved fixing the fractured bone with screws, aims to stabilize the joint and allow for proper healing.


2. Rehabilitation Goals
The primary goals during the rehabilitation phase include:
- Restoring full range of motion (ROM) in the knee.

- Regaining strength in the muscles surrounding the knee.

- Improving stability and functional mobility.

- Reducing pain and swelling.


3. Exercises for Knee Extension and Flexion
At six weeks post-surgery, you should be focusing on both knee extension (straightening) and flexion (bending) exercises. Here’s how to approach these:
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Knee Extension Exercises:
- Straight Leg Raises: While lying down, keep your affected leg straight and lift it to the height of your opposite knee. Hold for a few seconds and lower it back down. Repeat 10-15 times.

- Wall Slides: Sit with your back against a wall and your feet flat on the floor. Slowly slide your back down the wall while bending your knees, then slide back up to the starting position. This helps in achieving extension as you slide back up.

- Heel Slides: While lying on your back, slide your heel towards your buttocks, bending your knee. Then, slide it back out to straight. This can help with both flexion and extension.

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Knee Flexion Exercises:
- Seated Knee Flexion: Sit on a chair with your feet flat on the ground. Slowly slide your foot back, bending your knee as far as comfortable, then return to the starting position.
- Towel Stretch: While sitting, place a towel around your foot and gently pull it towards you to stretch the knee. Hold for 15-30 seconds and repeat several times.

- Standing Heel Raises: Stand and hold onto a stable surface for support. Slowly raise your heels off the ground, keeping your knees straight, and then lower back down.


4. Strengthening Exercises
Once you have regained some range of motion, you can start incorporating strengthening exercises:
- Quadriceps Sets: Sit with your leg straight and tighten the muscle on the top of your thigh. Hold for a few seconds and release. Repeat 10-15 times.

- Hamstring Curls: Stand and bend your knee, bringing your heel towards your buttocks. Hold for a moment and lower back down. This can be done with or without resistance.

- Step-Ups: Use a low step or platform. Step up with your affected leg, then step down. This helps improve strength and stability.


5. Monitoring Progress
As you progress, it is crucial to monitor your pain levels and swelling. If you experience increased pain or swelling after exercises, it may be a sign to reduce intensity or volume. Always consult with your physical therapist or orthopedic surgeon regarding your rehabilitation plan.


6. Consulting with Professionals
Regular follow-ups with your healthcare provider are essential to assess healing and adjust your rehabilitation program as needed. They may recommend physical therapy sessions to ensure you are performing exercises correctly and to provide additional modalities such as ultrasound or electrical stimulation if necessary.


7. Long-Term Considerations
As you recover, focus on building a strong foundation of strength and stability in your knee. This will not only aid in your recovery but also help prevent future injuries. Once you have regained sufficient strength and range of motion, your healthcare provider may guide you on returning to sports or physical activities.

In conclusion, rehabilitation after a tibial plateau fracture and ACL tear requires a structured approach focusing on range of motion, strength, and stability. By following a comprehensive exercise program and working closely with your healthcare team, you can achieve optimal recovery and return to your desired activities.