This protocol is intended to be a general outline only. The physician reserves the right to either advance or delay this protocol as deemed necessary. See PT prescription for unique instructions based on individual patients.  

Guidelines for Ambulation / TROM Post-Op Immobilizer Brace

  • Bilateral axillary crutches to be used immediately post-op for WBAT gait unless meniscus is repaired.
  • Meniscal Repairs Restrictions:
    • Small and Stable Repair:
    • No PROM restrictions. Progress ROM per normal ACL protocol.
    • Maintain NWB status with brace locked in extension for 2 weeks.
    • At end of Week 2, WBAT with TROM locked in extension for 2 more weeks and wean off crutches.
    • At end of Week 4, FWB’ing and advance to unlocking TROM, then removing brace. Patient must demonstrate excellent quadriceps control.
    • Large Repair:
    • No PROM restrictions. Progress ROM per normal ACL protocol.
    • Maintain NWB status with brace locked in extension for 4 weeks.
    • At end of Week 4, WBAT with TROM locked in extension for 2 weeks and wean off crutches.
    • At end of Week 6, FWB’ing and advance to unlocking TROM, then removing brace. Patient must demonstrate excellent quadriceps control.
    • Unstable Repair:
    • PROM limited to 90 degrees for first 4 weeks, then progress per ACL protocol.
    • Maintain NWB status with brace locked in extension for 4 weeks.
    • At end of Week 4, WBAT with TROM locked in extension for 2 more weeks and wean off crutches.
    • At end of Week 6, FWB’ing and advance to unlocking TROM, then removing brace. Patient must demonstrate excellent quadriceps control.
    • Maintain NWB with brace locked in extension for 6-8 weeks
    • After Week 6-8, WBAT with TROM locked in extension, wean from crutches.

 

  • TROM may be removed for bathing, icing, and exercises.
  • TROM brace may be unlocked for slight flexion in sitting for short periods of time and for driving.

Precautions

  • No closed-chain knee flexion for first eight weeks.
  • No resisted hamstring exercises (open or closed chain) for first three weeks.
  • No squats or lunges past 45 degrees of flexion for 16 weeks.
  • Avoid hyperextension of knee.
  • Knee flexion ROM performed in supine or prone to tolerance is allowed.
  • For all meniscus repairs: no running until 16 weeks post-op.
  • FOR BUCKET HANDLE TEARS ONLY: Knee flexion may be limited to 90 degrees for the first 4-8 weeks depending on size of repair. Any ROM restriction will be indicated on PT prescription.

 

Guidelines for Wound Care

  • Place occlusive dressing over steri-strips at wound sites at first visit. Change occlusive dressing daily, leaving steri-strips on unless they come off easily. Cover old steri-strips with new ones if needed.
  • Keep wound sites covered with occlusive dressing for showering