Rehabilitation of a Stroke Hemiplegia Case with Bilateral Permanent Dislocation of the Patella.

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Permanent patellar dislocation is a relatively rare disorder of the knee and it is particularly rare to be first found in older patients as described by Hamase (1988) and Torisu (1981). We report a 66 year-old female who was admitted for rehabilitation and was found to have an extreme knee deformity for the first time. After a few weeks self-care and use of a wheel chair were able to be performed independently but regarding gait exercises, the patient could not walk out of the parallel bars because of poor improvement in muscle strength in spite of our prescription of LLB (involved side) and knee brace (uninvolved side). As a next step and in a rather experimental trial, we removed her knee brace and changed LLB to SLB. Finally the patient could walk independently corresponding to a general improvement in her ADL.We analysed her gait from a biomechanical aspect and concluded that hip internal rotation during walking compensated for her malalignment and braces helped to prevent this original movement.
西日本整形・災害外科学会の論文