Rehabilitation From Tibial Plateau Knee Surgery
The tibial plateau is located on the upper surface of your tibia just below your kneecap. This region of your tibia is prone to fracture in high-impact accidents in sports such as football and skiing, or in car accidents. The tibial plateau is located inside your knee joint capsule, therefore a fracture to this region can also damage structures of your knee. Therefore, rehabilitation from a tibial plateau fracture may involve more than just allowing the bone to heal. The ligaments and tendons located inside your knee joint capsule may have suffered damage as well, making rehabilitation from a tibial plateau injury more involved. Always seek immediate medical attention after incurring a tibial plateau injury.
Stage 1
In the first stage of rehabilitation from a tibial plateau fracture, your knee must be immobilized for six to eight weeks to allow your tibial plateau to heal. This is usually done by placing your knee in a cast or solid brace. Like any bone fracture, you must allow the bone to heal by keeping it still. Failure to properly immobilize your knee after a tibial plateau fracture may result in a non-union fracture in which your bone will not heal properly, or the healing process will be significantly delayed.
- In the first stage of rehabilitation from a tibial plateau fracture, your knee must be immobilized for six to eight weeks to allow your tibial plateau to heal.
Stage 2
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Once your tibial plateau has fused together, your cast or hard brace may be removed. This marks the end of the first stage of rehab and the beginning of the second. In this stage, you will attempt to regain range of motion in your knee with flexibility training. Flexibility training may involve passive and active stretching. Passive and active stretching are techniques used by physical therapists to regain range of motion in your knee following months of immobilization. In passive stretching, a physical therapist will manually move your knee in different directions while you lie or sit passively on a table. In active stretching, you will move your knee through its range of motion under your own power.
- Once your tibial plateau has fused together, your cast or hard brace may be removed.
- In active stretching, you will move your knee through its range of motion under your own power.
Stage 3
As you begin to regain range of motion in your knee joint, it is also necessary to strengthen the muscles that support your knee. After months of immobilization following a tibial plateau fracture, the muscles that support your knee will atrophy, or lose size and strength. Because a tibial plateau fracture is often associated with other joint capsule injuries, every muscle that crosses your knee joint should be strengthened to increase the stability of your joint capsule. This includes your hamstrings and calves in addition to your quadriceps. Your physical therapist will direct you through the proper strengthening exercises that are specific to your needs.
- As you begin to regain range of motion in your knee joint, it is also necessary to strengthen the muscles that support your knee.
Stage 4
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Once your physician has determined that your tibia bone has completely fused and your physical therapist has determined that you have regained adequate range of motion and strength around your knee, you may return to normal activity. However, your physical therapist may require that you continue the range of motion and strength training exercises you completed during stages two and three of your rehabilitation to maintain flexibility and strength. This may protect your tibial plateau and knee joint capsule from re-injury and ensure long-term recovery.
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References
- "Essentials Of Strength Training And Conditioning"; Thomas R. Baechle and Roger W. Earle; 2000
- "Therapeutic Exercise: Foundations and Techniques (5th edition)"; Carolyn Kisner and Lynn Colby; 2007
- Malik S, Rosenberg N. Tibial Plateau Fractures. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Updated June 18, 2019.
- APrat-Fabregat S, Camacho-Carrasco P. Treatment strategy for tibial plateau fractures: an update. EFORT Open Rev. 2017;1(5):225–232. Published 2017 Mar 13. doi:10.1302/2058-5241.1.000031
- Markhardt BK, Gross JM, Monu JU. Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Radiographics. 2009;29(2):585-97. doi:10.1148/rg.292085078
- Vasanad GH, Antin SM, Akkimaradi RC, Policepatil P, Naikawadi G. Surgical management of tibial plateau fractures - a clinical study. J Clin Diagn Res. 2013;7(12):3128–3130. doi:10.7860/JCDR/2013/7249.3894
- American Academy of Orthopaedic Surgeons, OrthInfo. Fractures of the proximal tibia (shinbone). Updated May 2019.
- van der Vusse M, Kalmet PHS, Bastiaenen CHG, van Horn YY, Brink PRG, Seelen HAM. Is the AO guideline for postoperative treatment of tibial plateau fractures still decisive? A survey among orthopaedic surgeons and trauma surgeons in the Netherlands. Arch Orthop Trauma Surg. 2017;137(8):1071–1075. doi:10.1007/s00402-017-2718-7
Writer Bio
Joe King began writing fitness and nutrition articles in 2001 for the "Journal of Hyperplasia Research" and Champion Nutrition. As a personal trainer, he has been helping clients reach their fitness goals for more than a decade. King holds a Bachelor of Science in kinesiology from California State University, Hayward, and a Master of Science in exercise physiology from California State University, East Bay.