Acute Phase I: (0-2 weeks)
Goals:
- Alleviate acute pain and swelling
- Increase ROM
- Increase hip, hamstring and quadriceps strength
Plan
- NWB crutches for 6 weeks locked full extension
- Passive ROM as tolerated
- Begin isometric quad sets in full extension immediately
- Aquatic therapy after incisions healed
- Hamstring and gastroc stretching
- Patellar mobilization
- Hamstring and quadriceps co-contraction
- 4-Quad (hip flexion, abduction, adduction, extension)
- Modalities for pain and edema control
Sub-Acute Phase I: (2-6 weeks)
Goals:
- Decrease swelling
- Increase ROM
- Increase strength hip/knee
- Improve general conditioning
Plan
- Continue Phase I exercises
- Begin closed kinetic chain exercises
- Bicycle as tolerated
- N-K for hamstrings only
- ROM knee flex/ext as tolerated
- Aquatic therapy
- EMG Biofeedback
- Assess for patellar taping benefit
Phase II: (6-12 weeks)
Goals:
- Promote independent ambulation w/o assistive device
- Full ROM (pain free)
- Increase functional strength
Plan
- Continue Phase II exercises
- Increase closed chain activities
- Proprioceptive and balance training BAPS and trampoline
- Retro ambulation
- Calf and hip PRE’s
- Muscle endurance activities
- Functional closed chain exercises for static and dynamic patellar stabilization
- Nordic track. Progress to Stairmaster/Versaclimber
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