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.
