Extensor Mechanism Repair

Post-op:

• Long lever hinged knee brace locked in full extension. Patients to be nonweight bearing.
• TAQs

2 weeks:

• Removal of sutures
• Brace opened to 30º flexion (unless stated otherwise in post-op instructions)
• Remain NWBing
• Hip abduction/extension exercises

3 weeks:

• Begin PWBing
• Static and inner range quads
• Brace opened to 50º flexion
• Assess patellar mobility – passive mobilisations as required

4 weeks:

• Straight leg raise exercises
• Brace opened to 70º flexion

6 weeks:

• Brace opened to 90º flexion
• Progress to FWB over next 2-3 weeks
• Start single leg balance work
• Avoid hip extension with knee flexion until 12/52; i.e. quads stretches

8 weeks:

• Brace removed
• Aim to increase flexion to FROM
• Static bike

12 weeks:

• Progressive weight-bearing and functional quads strengthening
• Begin quads stretches (knee flexion with hip extension)
• Avoid jumping and contact sport for at least 6 months post surgery

12 – 18 months:

• There are different methods of protecting the repair with different materials
  used or auto or allograft ligaments. Some of them (such as the cerclage wire
  shown in the patient information) may need a second operation to remove them, once it is safe to do so.

Written by: Professor MJ McNicholas, Consultant Orthopaedic Surgeon
Mr Phil Ellison, Orthopaedic Physiotherapy Specialist
Mr Richard Norris, Orthopaedic Physiotherapy Specialist
Ratified by: Mr MJ McNicholas, Consultant Orthopaedic Surgeon
Date last reviewed: November 2020