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Our daughter is a tomboy all over. She has broken more bones than the rest of our kids put together. Her most recent injury was a completely ruptured quadriceps tendon. It's been surgically repaired and she's in rehab. The surgeon told her to move it within a safe range. What does that mean? She's going to need more directions than that!

It would be best to find out directly from the surgeon just what he or she had in mind with that precaution. If your daughter is in physical therapy, the therapist will also know what postoperative limits must be followed. After the tendon is repaired (and before closing the skin up), the surgeon takes the knee through a range-of-motion to find the stress point. That's the place where excess force would be needed to move the knee further. The surgeon usually tells the patient not to move the knee past this point. Most of the time, it does not go past 90 degrees of flexion. But again, you'll want to double-check this with the surgeon. The reason for this guideline is to avoid rupturing the healing tendon. Too much stress and the repair could rupture just like the tendon did the first time. Usually the patient is in a brace for the first two weeks. At the end of two weeks, the brace can be taken off to do range of motion exercises. These are prescribed with a safe amount of motion. Full motion can be resumed when the brace is removed (around the end of six weeks post-op). Full healing doesn't occur until three to four months after the surgery. The patient may continue to wear the brace during this time. The surgeon decides when the patient can stop wearing the brace and put full weight on the leg. Strengthening of the quadriceps muscle begins when full healing has occurred.

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