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Thursday, April 17, 2014
Knee surgery and gymnastics
My daughter is scheduled to have something similar to what is called the Fulkerson Procedure on her knee. She is a college gymnast and has dislocated her patella four times. Her doctor said the surgery was the only option at this point. My question is will she be able to rehab to return to her current level of gymnastics and if so, how long should it take?
This procedure has many variables that can impact healing. Assuming the procedure will take place below the patella and that the physician will reposition the tibial tuberosity, your daughter will most likely be non/partial weight bearing for 6-8 weeks. During that time her therapists will be monitoring inflammation, restricted range of motion and level of bony healing (xray). The thought is to help realign the inferior pull on the patella which should help reduce forces that lead to subluxation and or dislocation.
The chain of forces moves through the quads, quad tendon, patella, patella tendon, and the attachment at the tibial tuberosity. Her sport requires her to generate both acceleration and deceleration forces which stress these structures quite frequently. As for your specific question of how will she respond to rehab and will she be able to compete at her current/previous level, that is very case specific. Some follow-up questions for her orthopedic surgeon may be (if you have not already asked):
1. How many of these procedures have you done?
2. How many on elite athletes?
3. How many on intercollegiate gymnasts and how many have returned to competition?
Best of luck to you and your daughter.
Alex K Wong, MS, ATC
Assistant Athletic Lecturer & Trainer
College of Medicine
The Ohio State University