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Clinical Practice

Measurement

Session: Physical Therapy Management of a Female Patient 6 Weeks Post Operative Tibial Tubercle Transfer due to Chronic Patella Instability: a Case Report

Physical Therapy Management of a Female Patient 6 Weeks Post Operative Tibial Tubercle Transfer Due to Chronic Patella Instability: A Case Report

Sunday, November 3, 2024
9:30 AM – 10:30 AM  
Location: ROOM: Chantilly Foyer REGION: Tower Lobby Level >>> DIRECTIONS: From the ACRM Registration desk, proceed towards the elephants. The Chantilly Foyer is immediately behind the elephants.

    Presenting Author(s)

  • Trent Jackman, Physical Therapist

    Director of Clinical Education
    Idaho State University
    Chubbuck, Idaho, United States

    • Non-presenting Author(s)

  • AS

    Andrew Sturgill

    Student Physical Therapist
    Idaho State University
    Pocatello, Idaho, United States

Research Objectives: To describe early physical therapy evaluation for a patient with post operative tibial tubercle transfer (TTT) due to chronic patella instability.
To investigate effective objective outcomes for management of TTT.
To describe appropriate interventions for management of TTT.

Design: Single case report. The duration of follow-up was 1-2x weekly for 12 weeks.

Setting: The study setting was located in a rural county hospital outpatient setting.

Participants: There was 1 experimental subject for the case report.

Interventions: Modalities included electric stimulation (interferential and Russian) as well as ultrasound. Vasopneumatic & Blood Flow Restriction to the affected lower extremity. Manual therapy, stretching, strengthening with resistive bands, Bulgarian Split squats, and functional gait training were also implemented weekly over 12 weeks.

Main Outcome Measures: Patient Functional Report, Knee Active Range of Motion, Manual Muscle Testing, Verbal Pain Scale, Lower Extremity Functional Scale, Dynamic Gait Index, and Berg Balance Test were used to measure outcomes.

Results: The patient demonstrated improvements in the Lower Extremity Functional Scale from 13/80 (initial evaluation) to 55/80 (week 12). She also improved her Dynamic Gait Index where she was unable to complete the test to 22/24 at discharge. She was also unable to complete the Berg Balance Test initially but scored 56/56 at discharge while improving her pain rating from 7/10 initially to a 3/10 at discharge. Her range of motion improved from 95-120 degrees knee flexion at discharge. Her manual muscle testing also improved from 3-/5 to 4+/5.

Conclusions: Physical Therapy management improved patient range of motion, strength, pain, balance, and function after TTT surgery. Additional studies are needed before the information should be used as a generalization in usual clinical settings.

Author(s) Disclosures: The authors do not have any conflicts.

Learning Objectives:

  • Upon completion, participants will be able to identify impairments associated with post operative tibial tubercle transfer surgery.
  • Upon completion, participants will be able to utilize various physical therapy outcome measures related to tibial tubercle transfers.
  • Upon completion, participants will be able to describe potential physical therapy interventions for patients recovering from tibial tubercle transfer surgery.