Rehabilitation for A 10-Year-Old Patient Without Left Patella Bone Post Total Patellectomy: A Case Report Fatrika Dewi, Marietta Shanti, Ellyana Sungkar, Arnengsih Nazir
Department of Physical Medicine and Rehabilitation, Faculty of Medicine,
Padjadjaran University, Dr. Hasan Sadikin Academic Teaching Hospital,
Bandung, Indonesia
Abstract
Overview: Total patellectomy was conducted for cases with disrupted extensor mechanism with loose component and poor bone stock. Patients should immobilize for 6-8 weeks post operation. During this time the patients were allowed to begin partial weight bearing. At 3 months post operative, full weight bearing was allowed and full range of motion was encouraged as tolerated.
Case description: A 10-Year-Old patient was consulted to rehabilitation clinic for rehabilitation after undergoing muscle and patellar tendon repair with patellectomy. Patient complaint unable to stand and walk. She got lower extremity orthosis. She was trained to stand and walking using Knee Ankle Foot Orthosis (KAFO).
Discussion: Due to patellectomy, there will be disruption of the extensor mechanism. Extensor mechanism is responsible for extending the tibiofemoral joint. Patella serves as a mechanical pulley for quadriceps and contribute to increase progressive extension. Without patella, the patient will lose stability when doing activities, so the patient needs KAFO to stabilize the knee motion. After 6 months rehabilitation, the patient can walk independently and there were improvements in quality of life of patient.
Conclusion: The management of patient post patellectomy has good functional prognosis for mobilization using knee orthosis
