Rehabilitation After Tibial Plateau Fracture Surgery: When to Start? - Rehabilitation

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Rehabilitation after a tibial plateau fracture surgery, especially when accompanied by an anterior cruciate ligament (ACL) tear, is a critical aspect of recovery that requires careful planning and execution. Given your recent surgery on November 30, it’s essential to understand the timeline and the appropriate activities to engage in during your recovery.

When to Start Rehabilitation:
1. Initial Recovery Phase: After surgery, the primary focus is on healing. Typically, patients are advised to wait until the surgical site has stabilized before beginning any formal rehabilitation. This usually means waiting until the initial swelling has decreased and the pain is manageable. In many cases, this can take anywhere from a few days to a couple of weeks post-surgery.

2. Post-Operative Follow-Up: It’s crucial to attend your follow-up appointments with your orthopedic surgeon. They will assess the healing process through physical examination and imaging studies, such as X-rays. Generally, rehabilitation can begin as soon as the surgeon confirms that the fracture is stable and that there are no complications.

3. Timeline for Rehabilitation: For tibial plateau fractures, rehabilitation often starts around 2 to 4 weeks post-surgery, depending on the specific nature of the fracture and the surgical intervention performed. If you had a fixation with plates and screws, you might be able to start gentle range-of-motion exercises sooner than if you had a more complex procedure.

4. ACL Considerations: Since you also have an ACL tear, the timeline for rehabilitation may be adjusted. Typically, ACL reconstruction is performed after the fracture has healed sufficiently, which can take about 3 months. However, some gentle rehabilitation exercises focusing on range of motion and muscle activation can begin earlier, as long as they do not place undue stress on the healing structures.

Home Exercises and Muscle Strengthening:
While you are at home recovering, there are several low-impact exercises you can perform to maintain muscle strength and prevent stiffness:
1. Ankle Pumps: While lying down or sitting, flex and point your toes to promote circulation and prevent blood clots.

2. Quadriceps Sets: Sit with your leg extended and tighten the muscles on the top of your thigh (quadriceps) for 5 seconds, then relax. Repeat this several times.

3. Straight Leg Raises: While lying down, keep one leg bent and the other straight. Slowly lift the straight leg to the height of the bent knee, hold for a few seconds, and lower it back down.

4. Heel Slides: While sitting or lying down, slide your heel towards your buttocks, bending your knee as much as comfortable, then slide it back out.

5. Gentle Range of Motion Exercises: If approved by your surgeon, you can gently bend and straighten your knee to maintain flexibility.

Consulting with a Physical Therapist:
Once you receive clearance from your surgeon, working with a physical therapist is highly recommended. They can provide a tailored rehabilitation program that focuses on:
- Restoring range of motion
- Strengthening the muscles around the knee and hip
- Improving balance and proprioception
- Gradually increasing weight-bearing activities
Conclusion:
In summary, the timing for starting rehabilitation after tibial plateau fracture surgery should be guided by your surgeon’s recommendations, typically beginning within a few weeks post-surgery. Engaging in gentle exercises at home can help maintain muscle strength and flexibility during the initial recovery phase. Always consult with your healthcare provider before starting any new exercise regimen to ensure it aligns with your recovery goals and current condition.