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. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.
Guidelines for Crutches and TROM Brace

  • Bilateral axillary crutches to be used immediately post-op, WBAT unless otherwise specified.  Patient will gradually reduce use of crutches once able to perform SLR independently.
  • TROM brace usage:
    • To be fitted at 1st post-op visit and worn with all ADL’s for first 2-4 weeks, initially locked at 0o extension for all weight-bearing activities.
    • To be removed only for sleeping, bathing, and exercises.
    • Unlock brace for ambulation when able to perform good quad set and independent SLR.
    • Discharge TROM for everyday use when patient has normal gait pattern, can perform SLR without quad lag, and maintains 0o knee extension at rest – usually within first four weeks.
    • Continue use of TROM for first 8-10 weeks when on unstable surfaces or in large crowds, or when on feet for extended period of time.

Initial goals/precautions: 

  • Achieve full ROM by 8-10 weeks post-op
  • Avoid hyperextension of knee
  • No deep squats or lunges past 45 degrees of knee flexion until 16 weeks post-op
  • No running until 4 months post-op
  • No torsion or cutting drills till 6 months post-op
  • No sports till 8 months post-op

Guidelines for Wound Care

  • Place occlusive dressing over steri-strips at wound sites at first visit. Change occlusive dressing every other day, leaving steri-s