Physical Therapy After Patella Lateral Release Surgery

If you have had a lateral release surgery to correct a dislocating patella, you may benefit from physical therapy to improve your mobility. Your PT can help guide you during your rehab after a lateral release.

The patella (kneecap) is a bone in the front of the knee joint that helps improve the performance of quadriceps muscle on the top of the thigh. There is a groove in the end of the femur (thigh bone) where the patella resides. If your patella moves out of its groove and then snaps quickly back into place, a subluxation has occurred. If the patella moves out of its groove and stays out of place, a complete patella dislocation has occurred.

If you have suffered a patella dislocation, then you may understand how painful this condition may be. A dislocated patella can cause loss of knee range of motion, swelling around the knee, or loss of strength in the muscles that support the knee. It can limit your ability to walk, run, or function normally in your day-to-day activities.

A physical therapist working with a man's knee
Colin McPhearson / Getty Images

After you dislocate your patella, your healthcare provider will reduce the dislocation. This means that the kneecap will be manually pushed back into the groove at the end of your thigh bone. You may be referred to physical therapy for treatment for the dislocated patella. There you may work to regain normal knee mobility and function and to decrease knee pain.

While physical therapy for a dislocated patella may be successful, occasionally the patella continues to dislocate. This may be caused by tightness in the structures on the outside part of the kneecap or by weakness in the muscles that support the knee. This frequent dislocation can cause a great deal of pain and limit normal recreational, athletic, or work activity.

Surgery for a Dislocated Patella

If you have suffered from a recurring dislocation of the patella or if you have suffered a severe dislocation, surgery may be an option for you. One of the most common surgical procedures for a dislocated patella is a lateral release surgery. During this surgery, the tight tissue on the outside, or lateral, part of the knee is cut and lengthened. This allows the patella to sit properly in its groove.

Immediately after surgery, you may be required to wear a knee immobilizer to keep the joint protected and in a position of extension. Be sure you understand how to fasten your immobilizer and that you are wearing it properly.

Physical Therapy After Lateral Release Surgery

Initial Treatment

After a lateral release surgery, you may be referred to physical therapy reahbilitation. Your therapy will most likely begin with an initial evaluation where measurements of range of motion, strength, and swelling will be taken. Your healthcare provider may require that you wear a knee brace, and your physical therapist may check to see that you are wearing it properly.

The initial goals of physical therapy after lateral release are to improve mobility and strength, progress walking with crutches to walking with no device, and to control pain and swelling. This is accomplished by common treatment techniques that may include:

  • Knee exercises
  • Hip exercises
  • Ice
  • Ultrasound
  • Electrical Stimulation
  • Gait training

The focus of your exercises during the initial phase is to improve the function of the muscles on the top and bottom of your thigh and to improve basic hip muscle function.

Minimal Protection Phase

At about four to five weeks after surgery, you should be able to tolerate more stress and force through the knee. You will probably no longer require crutches for walking, and your pain and swelling level should be at a minimum. At this point, your healthcare provider may also have you discontinue use of the knee brace. It is always best to check with your practitioner and physical therapist to be sure when you should stop using the brace. You may still need to use the brace for athletic or vigorous activity.

You may also begin working on restoring normal balance during this phase after surgery. Basic balance exercises can be performed to help ensure the knee is functioning properly.

Exercises to restore normal strength and mobility are the main focus in this phase. Advanced hip-strengthening exercises may be started to help you return to normal walking and running. Approximately eight weeks after surgery walking should be normal and you should be able to tolerate light jogging. Again, be sure to work closely with your surgeon and physical therapist to be sure you are ready to jog and run.

Return to Normal Function

The return to function phase should focus on exercises that place maximal stress on the knee to ensure that the patella and supporting structures can tolerate the loads that you may encounter during your normal activities. If you are returning to sports, plyometric drills can help you prepare to tolerate running, starting and stopping, and jumping.

An important caveat when jumping and landing: be sure to keep your knees directly over your ankles and toes. Do not allow your knees to glide inwards while jumping and landing. Your PT can show you the best way to work on this.

A Word From Verywell

If you are suffering from episodes of patella dislocations or subluxations, your healthcare provider may recommend a lateral release surgery to help keep the patella in place. Physical therapy after surgery is essential to ensure a safe return to your normal activity and function. Understanding the post-op protocol for lateral release surgery can help guide you in your rehabilitation.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Manske RC, Prohaska D. Rehabilitation following medial patellofemoral ligament reconstruction for patellar instability. Int J Sports Phys Ther. 2017;12(3):494-511.

  3. Hing CB, Smith TO, Donell S, Song F. Surgical versus non-surgical interventions for treating patellar dislocation. Cochrane Database Syst Rev. 2011;(11):CD008106. doi:10.1002/14651858.CD008106.pub2

  4. American Academy of Orthopaedic Surgeons, OrthoInfo. Patellar dislocation and instability in children (unstable kneecap).

  5. Tan SHS, Chua CXK, Doshi C, Wong KL, Lim AKS, Hui JH. The outcomes of isolated lateral release in patellofemoral instability: a systematic review and meta-analysis. J Knee Surg. 2019. doi:10.1055/s-0039-1688961

  6. Felli L, Lovisolo S, Capello AG, Chiarlone F, Formica M, Alessio-Mazzola M. Arthroscopic lateral retinacular release and modified Goldthwait Technique for patellar instability. Arthrosc Tech. 2019;8(11):e1295-e1299. doi:10.1016/j.eats.2019.07.001

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.