Immediate Postoperative Phase (0-7 days after surgery)

  • Wait until your first physical therapy visit for the therapist to change the dressing for you.
  • Perform sponge baths or shower with saran wrap covering surgical site.
  • If you experience malaise, fever, or chills - contact your physician immediately.
  • Control acute inflammation with cryotherapy 15-20 minutes hourly, rest, elevation.
  • Start Physical Therapy 5 days after surgery.
  • Ambulation: Touch down weight bearing with use of bilateral axillary crutches and postoperative brace locked in extension until 4 weeks post op.
  • Therapeutic exercise to include ankle pumps, calf and hamstring flexibility, quad sets, SLR flexion, abduction, extension and heel slides with brace on.
  • Limit ROM 0-30 degrees.

Phase II (8 days -6 Weeks):

  • Open brace to accommodate comfortable ROM 10 degrees per week .
  • Touch down weight bearing until 4 weeks post-op with brace locked in extension with bilateral axillary crutches.
  • At 4 weeks post-op ambulation WBAT with brace locked in extension.
  • Active knee flexion within allowed ROM.
  • Continue quad set, SLR hip flexion, abduction, and extension.
  • May use stationary bicycle no resistance to work on ROM within restrictions.

Phase III (6-8 Weeks):

  • Open brace to accommodate ROM to tolerance.
  • Continue with brace locked in extension WBAT during ambulation.
  • Initiate active knee extension 90-45 degrees.
  • Continue active knee flexion.

Phase IV (8-12 Weeks):

  • Progress flexion range of motion to full as tolerated.
  • Open brace during ambulation.
  • Start closed chain strengthening to tolerance.
  • Start slow progressive resisted knee extension 90-45 degrees.
  • Initiate balance and proprioception .

Phase V (12 Weeks):

  • Continue strengthening and proprioception .
  • Initiate an interval jogging program.
  • Double leg plyometrics uniplanar.
  • Low level agility exercise.

Return to Activity Phase (16 weeks)

  • Double leg plyometrics multiplanar.
  • Single leg plyometrics uniplanar.
  • Advanced agility and running.
  • Return to Sport at 5-6 months with physician approval.