Acute Phase I: (0-2 weeks)
Goals:
- Alleviate acute pain and swelling
- Increase ROM
- Increase hip, hamstring and quadriceps strength
- Promote normal ambulation
- Maintain cardiovascular conditioning
Plan:
- ROM as tolerated
- Heel/wall slides for ROM
- Aquatic therapy
- Hamstring and gastroc stretching
- Kinesiotaping as necessary
- Bicycle as tolerated
- Patellar mobilization
- Hamstring and quadriceps co-contraction
- 4-Quad (hip flexion, abduction, adduction, extension)
- Modalities for pain and edema control
Sub-Acute Phase I: (2-4 weeks)
Goals:
- Decrease swelling
- Increase ROM
- Increase strength hip/knee
- Improve general conditioning
- Independent ambulation w/o assistive device
Plan:
- Continue Phase I exercises
- N-K for hamstrings only
- ROM knee flex/ext as tolerated
- Stairmaster, treadmill, Elliptical (Pain free)
- Universal equipment PRE’s – leg press ¼ – ½
- Proprioceptive and balance training BAPS and trampoline
- Calf raises,
- Aquatic therapy
- Avoid knee extension exercises
Phase III: (4-6 weeks)
Goals:
- Full ROM (pain free)
- Increase functional strength
Plan
- Continue Phase II exercises
- Increase closed chain activities
- Increase proprioception activity
WEIGHT BEARING |
BRACE |
ROM |
THERAPEUTIC EXERCISES** |
|
Initial post-op 0-6 weeks |
NWB with brace locked in full extension. |
0-90° for all activities (including sleeping) – remove for exercise and CPM use (if applicable). |
0-90°. |
AROM/AARPOM to tolerance, quad/ham/glut sets, ankle pumps, calf/ hamstring stretches***, SLR with brace locked in full extension, resisted plantarflexion.
|
At 6-8 weeks: |
advance to a protected gait pattern with crutches ( about 50% of your weight ) |
Removed for sleeping. |
Increase motion exercises to 120°. |
Progress exercises in first phase, SLR without brace if able to maintain full extension, initiate stationary bike with low resistance.
|
8 weeks- 12 weeks |
Full, without use of crutches and with a normalized gait pattern. |
D/C per physician. |
Progress to full and pain free. |
Mini-squats 0-45°-, leg press 0-60°, closed chain terminal knee extensions, toe raises, balance activities, hamstring curls, increase to moderate resistance on bike.
|
EXPECTED RECOVERY:
- Walking without crutches approximately 6-8 weeks after surgery
- Back to work within 3-4 months following surgery if laborer, desk type work may return 2-3 weeks following surgery.
- Progress back to sports after 3-4 months