Rehab Knee ACL & PCL Reconstruction
  • Sports Medicine

  • Knee Surgery

  • Shoulder Surgery

  • Elbow Surgery

  • Hip Surgery

  • Ankle Surgery

  • Arthroscopic Surgery

Rehab Knee ACL & PCL Reconstruction

Phase I: Acute

Goals:

  • Alleviate acute pain and swelling
  • Passive ROM to tolerance(emphasize 0° extension)
  • Increase hamstring and quadriceps strength
  • Promote comfortable ambulation WBAT with brace and crutches
  • Maintain cardiovascular conditioning

Plan: (0-1 week)

  • Weight bearing as tolerated with crutches
  • Brace locked in full extension all times, No ROM
  • Quad sets
  • Patellar mobilization
  • Ankle pumps
  • SLR
  • Hip Ab/Adduction
  • Calf press with theraband progressing to standing toe raises with full knee extension
  • Hamstring and calf stretching
  • Standing hip extension
  • Modalities for pain and edema control

Plan: (1-4 weeks)

  • Weight bearing as tolerated with crutches
  • ROM passive only to tolerance (**Maintain anterior pressure on proximal tibia as knee is flexed – prevent posterior sagging at all times**)
  • Quad sets
  • Patellar mobilization
  • Ankle pumps
  • SLR
  • Hip Ab/Adduction
  • Calf press with theraband progressing to standing toe raises with full knee extension
  • Hamstring and calf stretching
  • Standing hip extension
  • Modalities for pain and edema control

Phase II (4-12 weeks)

Goals:

  • Decrease swelling and prevent atrophy
  • Increase hip strength
  • Stimulate collagen healing
  • Independent ambulation without crutches
  • Continue general conditioning

Plan: (4-8 weeks)

  • Weight Bearing: As tolerated w/ crutches (gradually discontinue after 6-8 weeks)
  • Brace: 4-6 weeks: Unlocked for gait training/exercises only.
  • 6-8 weeks: Gradually discontinue
  • 8 weeks: Discontinue use
  • ROM: Maintain full extension and progressive flexion
  • Continue phase I exercises
  • Continue patellar mobilization and ROM activities
  • Continue hamstring and calf stretching
  • Gait training
  • Wall slides and Mini-squats
  • Resisted hip exercises in standing (**Resistance must be proximal to knee with hip ab/adduction exercises)

Plan: (8-12 weeks)

  • Weight Bearing: as tolerated w/ crutches (gradually discontinue after 6-8 weeks)
  • Brace: 4-6 weeks: Unlocked for gait training/exercises only.
  • 6-8 weeks: Gradually discontinue
  • 8 weeks: Discontinue use
  • ROM: Maintain full extension and progressive flexion
  • Stationary bike with light resistance (to begin) and seat higher than normal
  • Closed chain terminal knee extensions
  • Stairmaster
  • Balance and proprioception activities
  • Leg press (limiting knee flexion to 90)

Phase III (12 weeks to 9 months)

Goals:

  • Full ROM
  • Continue all goals from Phase II

Plan: (12 weeks to 9 months)

  • Weight bearing Full, without use of crutches and with a normalized gait pattern
  • ROM gain full and pain free
  • Advance closed chain strengthening
  • Progress proprioception and balance activities
  • Maintain flexibility
  • Begin treadmill walking to jog progression

Phase IV (9 months and beyond)

  • Weight bearing Full
  • Maintain strength, endurance, and function
  • Begin sport-specific functional progression (backward running, cutting, grapevine, etc.) Progress to running
  • Initiate a plyometric program
  • Rehab modified with concomitantly performed meniscus repair, articular cartilage procedure, or posterolateral corner reconstruction

**TTWB x 6 wks if Meniscus Repair

Please forward a progress report via fax or e-mail at least one day prior to the next MD visit or give to the patient to hand deliver.