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Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

Institutional price:	$684.00
Issues per year:	4

Best Paper Award Selection - Editorial Board Site

2007, Volume19

94 pages

DOI: 10.1615/CritRevPhysRehabilMed.v19.i2

Issue price - $190.00

A Systematic Review Investigating the Early Rehabilitation of Patients Following Medial Patellofemoral Ligament Reconstruction for Patellar Instability

Toby O. Smith
Orthopaedic Physiotherapy Research Unit, Physiotherapy Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK

Nicola Russell
Orthopaedic Physiotherapy Research Unit, Physiotherapy Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK

James Walker
Orthopaedic Physiotherapy Research Unit, Physiotherapy Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK

ABSTRACT

The objectives of this review were to determine the optimal postoperative weight-bearing status for medial patellofemoral ligament reconstruction (MPFL) patients; whether MPFL reconstruction patients should be immobilized postoperatively using knee braces, and for how long; and when and how these patients should commence exercising postoperatively. A literature search using the electronic databases AMED, British Nursing Index, CINAHL, Cochrane database, Embase, Medline (via Ovid), Physiotherapy Evidence Database (PEDro), PsycINFO, Pubmed, and Zetoc was performed from their inception to May 2007. All English language, human subject, clinical studies reporting the rehabilitation and outcome of patients following a MPFL reconstruction were included. Eight papers were evaluated. Three reviewers independently assessed the methodological quality of each of the studies using the CASP appraisal tool. The review reported that there appeared to be little differences in radiological or clinical outcomes between patients who were full weight bearing, began immediate active exercises, and were not immobilized in a knee brace, compared to those who were initially non−weight bearing, instructed not to exercise their knee, and were immobilized in a knee brace during the initial postoperative weeks. This should, however, be interpreted with caution since the evidence presented with numerous methodological limitations. Future study is recommended to address these methodological weaknesses.