Nonoperative treatment of a lateral patellar dislocation produces favorable functional results, but as high as 35% of individuals experience recurrent dislocations.» Medial patellofemoral ligament reconstruction is an effective treatment to prevent recurrent dislocations and yield excellent outcomes with a high rate of return to sport.» Both nonoperative and postoperative rehabilitation should center on resolving pain and edema, restoring motion, and incorporating isolated and multijoint progressive strengthening exercises targeting the hip and knee.» Prior to return to sports, both functional and isolated knee strength measurements should be used to determine leg symmetry strength and to utilize patient-reported outcome measures to assess the patient's perceived physical abilities and patellofemoral joint stability.
Blood flow restriction therapy (BFRT) involves the application of a pneumatic tourniquet cuff to the proximal portion of the arm or leg. This restricts arterial blood flow while occluding venous return, which creates a hypoxic environment that induces many physiologic adaptations.» BFRT is especially useful in postoperative rehabilitation because it produces muscular hypertrophy and strength gains without the need for heavy-load exercises that are contraindicated after surgery. » Low-load resistance training with BFRT may be preferable to low-load or high-load training alone because it leads to comparable increases in strength and hypertrophy, without inducing muscular edema or increasing pain.
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